Background Continuity of care is particularly important for patients with chronic conditions, such as type 2 diabetes (T2D). Continuity is shown to reduce overall health service utilization among people with diabetes, however, evidence... more
Background Continuity of care is particularly important for patients with chronic conditions, such as type 2 diabetes (T2D). Continuity is shown to reduce overall health service utilization among people with diabetes, however, evidence about how it relates to the utilization of outpatient specialist services in Norway is lacking. The aim of this study was to investigate continuity of GP care for people with T2D, and its association with the use of outpatient specialist health care services. Methods We used e-mail questionnaire data obtained from members of The Norwegian Diabetes Association in 2018. Eligible for analyses were 494 respondents with T2D and at least one GP visit during the previous year. By descriptive statistics and logistic regressions, we studied usual provider continuity (UPC) and duration of the patient-GP relationship and associations of these measures with somatic outpatient specialist visits. Analyses were adjusted for gender, age, education, self-rated health,...
Research Interests:
BACKGROUND Mobile health (mHealth) is publicized as a potential solution for the rising demand of healthcare’s limited resources and poor health outcomes. This is especially true for chronic illnesses such as diabetes, as mHealth... more
BACKGROUND Mobile health (mHealth) is publicized as a potential solution for the rising demand of healthcare’s limited resources and poor health outcomes. This is especially true for chronic illnesses such as diabetes, as mHealth increases the options for individuals to self-manage their health. These options can improve patients’ health knowledge, engagement and capacity to contribute to their own care decisions. However, there are few solutions for sharing and presenting patients’ mHealth data with healthcare providers (HCPs) in a mutually understandable way. This limits the potential of shared decision making. Therefore, data-sharing solutions should enable both parties to collaborate in their use of patient-gathered data (PGD) through shared decision making for health self-management. OBJECTIVE Through a 6-month mixed-method feasibility study, held in Norway, we explore the impacts that a system for sharing PGD from mHealth devices has on patients and HCPs during diabetes consul...
Research Interests:
BACKGROUND Introducing self-collected health data from patients with diabetes into consultation can be beneficial for both patients and clinicians. Patients can be more proactive in their disease management and clinicians can provide more... more
BACKGROUND Introducing self-collected health data from patients with diabetes into consultation can be beneficial for both patients and clinicians. Patients can be more proactive in their disease management and clinicians can provide more tailored medical services. In the best situation, EHRs should be able to receive self-collected health data in a medical data standard representation such as FHIR from patients systems such as mHealth apps and to display it directly to their users, the clinicians. However, while Norwegian EHRs are working on implementing FHIR, no solution or graphical interface is available today to display self-collected health data. OBJECTIVE The objective of this study was to design and assess a dashboard for displaying relevant self-collected health data from patients with diabetes to clinicians. METHODS The design relied on 1) consulting scientific literature dealing with health data presentation in combination with existing system providing self-collected hea...
Research Interests:
To test the association between self-rated health and self-rated degree of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and CFS/ME patients' assessment of quality of primary care, specialist care and coordination of... more
To test the association between self-rated health and self-rated degree of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME), and CFS/ME patients' assessment of quality of primary care, specialist care and coordination of care. Cross-sectional study. Self-reported questionnaire data from women members of The Norwegian ME Association obtained in 2013. 431 women with CFS/ME aged 16-73 years. The participants' assessment of quality in primary care, specialist care and in coordination of care (good/very good or poor/very poor). Main explanatory variables: self-rated health and self-rated degree of CFS/ME. Quality of care was rated poor by 60.6% in primary care, by 47.7% in specialist care, and by 71.2% regarding coordination of care. Poorer self-rated health increased the probability of rating quality in primary care poor, particularly among women 40 years and over (OR 2.38, 95% CI 1.63 to 3.49), women with university education (OR 2.57, CI 1.68 to 3.94), and owing to ...
Research Interests: Primary Care, Primary Health Care, Family Medicine, Norwegian, Adolescent, and 15 moreMedicine, Norway, Humans, Health Services, Female, Male, Young Adult, Patient Satisfaction, Aged, Middle Aged, Adult, Cross sectional Study, Cross Sectional Studies, Delivery of Health Care, and Quality of health care
Bodily conditions that are difficult to identify, explain and treat with the aid of medical knowledge and technology appear to be particularly challenging to medical encounters. Patients are often dissatisfied with the help they receive,... more
Bodily conditions that are difficult to identify, explain and treat with the aid of medical knowledge and technology appear to be particularly challenging to medical encounters. Patients are often dissatisfied with the help they receive, and they often experience that their medical needs are not met. To explore factors facilitating patient satisfaction among patients with a medically unexplained condition, we ask: what is the importance of individual versus relational factors in facilitating patient satisfaction in clinical encounters between general practitioners (GPs) and women with medically unexplained long-term fatigue? We approach this question through a statistical analysis of survey data collected from a net sample of 431 women recruited through a patient organisation for people suffering from myalgic encephalomyelitis in 2013. Participants were asked about their experiences with general practitioners in the Norwegian national health system in two different phases: shortly a...
Research Interests:
Continuity of care is important for patients with chronic illness in need of coordinated healthcare services from multiple providers. Little is known about how patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME)... more
Continuity of care is important for patients with chronic illness in need of coordinated healthcare services from multiple providers. Little is known about how patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) experience continuity of GP care. This study explores how women with CFS/ME experience GP care across the three dimensions of continuity: informational, management, and relational continuity. This cross-sectional study uses questionnaire data collected from members of The Norwegian ME Association. Descriptive statistics and logistic regressions were used to estimate experiences of continuity, and associations with age, education, self-rated degree of CFS/ME, duration of the GP relation (GP duration), and number of GP visits for CFS/ME-related issues during the previous year (GP frequency). Almost two-thirds of participants reported positive experiences across all three dimensions of GP continuity of care; 64.4% for informational, 64.1% for management, a...
Research Interests: General Practice, Primary Health Care, Chronic Fatigue Syndrome, Adolescent, Medicine, and 15 moreNorway, Library and Information Studies, Humans, Health Services, Female, Aged, Middle Aged, Adult, Public health systems and services research, Odds ratio, General practitioner, Cross sectional Study, Continuity of Patient Care, Cross Sectional Studies, and Logistic Models
Research Interests: General Practice, Family Medicine, Health Care, Medicine, Humans, and 11 moreHospitalization, Female, Male, Great Britain, Questionnaires, Public health systems and services research, Continuity of Patient Care, Cross Sectional Studies, Socioeconomic Factors, Health Services Accessibility, and Physician-Patient Relations
Additional file 1: Questionnaire.
Background The prevalence of diabetes and the use of electronic health (eHealth) are increasing. Lifestyle changes in a positive direction may reduce morbidity and mortality in patients with diabetes. The main objective of this study was... more
Background The prevalence of diabetes and the use of electronic health (eHealth) are increasing. Lifestyle changes in a positive direction may reduce morbidity and mortality in patients with diabetes. The main objective of this study was to test the association between lifestyle changes based on online information seeking and discussing the information with a doctor. Methods In this cross-sectional study we used e-mail survey data from 1250 members of The Norwegian Diabetes Association, collected in 2018. Included in the analyses were 847 men and women aged 18 to 89 years diagnosed with diabetes and who reported use of eHealth within the previous year. We used descriptive statistics to estimate lifestyle changes based on information from the internet. Logistic regressions were used to estimate the associations between lifestyle changes after online information seeking and discussing the information with a doctor. Analyses were adjusted for gender, age, education, and self-rated heal...
Research Interests:
Research Interests:
BACKGROUND In 2002 the Norwegian Board of Health made a survey of the accessibility of general practitioners in Troms county in North Norway. MATERIAL AND METHODS In a telephone interview one secretary in each surgery informed about... more
BACKGROUND In 2002 the Norwegian Board of Health made a survey of the accessibility of general practitioners in Troms county in North Norway. MATERIAL AND METHODS In a telephone interview one secretary in each surgery informed about telephone response time, planned time for telephone consultations, recorded numbers of urgent consultations, and waiting time to obtain a routine consultation. RESULTS On average, the planned telephone time was two hours per week. Telephone time was in inverse proportion to the number of patients on the doctor's list. Rural doctors spent twice as much time as urban colleagues on the telephone with their patients. Doctors with lists between 500 and 1500 patients had a higher proportion of urgent consultations compared with doctors with shorter or longer lists. INTERPRETATION Telephone response time below two minutes and waiting times for routine consultations below 20 days appear to be within acceptable norms. When patient lists are above 1500, doctor...
Research Interests:
Paper 3 er akseptert men ikke publisert enda i British Journal of General Practice (BJGP). Det er viktig at artikkelen ikke publiseres i Munin FOR den er publisert i BJGP.
Research Interests:
Background For people with Type 2 diabetes (T2D), lifestyle changes may be the most effective intervention. Online groups for people with diabetes holds a great potential to support such changes. However, little is known about the... more
Background For people with Type 2 diabetes (T2D), lifestyle changes may be the most effective intervention. Online groups for people with diabetes holds a great potential to support such changes. However, little is known about the association between participation in online groups and lifestyle changes based on internet information in people with T2D. The aim of this study was to investigate the association between self-reported lifestyle changes and participation in online groups in people with T2D. Methods We used e-mail survey data from 1,250 members of The Norwegian Diabetes Association, collected in 2018. Eligible for analyses were the 540 respondents who reported to have T2D. By logistic regressions we studied the association between self-reported lifestyle changes and participation in online groups. Analyses were adjusted for gender, age, education, and time since diagnosis. Results We found that 41.9 % of the participants reported lifestyle changes based on information from ...
Research Interests:
BACKGROUND Despite the increasing prevalence of diabetes and the increasing use of eHealth, little is known about the association between provider-based health services and eHealth among people with diabetes. This is the second study in a... more
BACKGROUND Despite the increasing prevalence of diabetes and the increasing use of eHealth, little is known about the association between provider-based health services and eHealth among people with diabetes. This is the second study in a project exploring the associations between the use of eHealth and the use of provider-based health services. OBJECTIVE The objective of this study was to investigate which eHealth services are used among out-of-hours (OOH) visitors with type 1 diabetes (T1D), and whether the use of eHealth (eg, apps, search engines, video services, and social media) was associated with the use of OOH services. We also wanted to investigate associations between anxiety, reassurance, and change in doctor-seeking behavior because of health information acquired from the Internet, and the use of OOH services. METHODS We used data from a 2018 email survey of members of the Norwegian Diabetes Association (18-89 years old). Respondents with T1D were eligible for analyses. ...
Research Interests:
Background Traditional and complementary medicine (T&CM) is commonly used by cancer patients in Northern Norway, in particular spiritual forms like traditional healing. T&CM is mainly used complementary to conventional cancer treatment... more
Background Traditional and complementary medicine (T&CM) is commonly used by cancer patients in Northern Norway, in particular spiritual forms like traditional healing. T&CM is mainly used complementary to conventional cancer treatment and is rarely discussed with conventional health care providers, increasing the risk of negative interaction with conventional cancer care. The aim of this study was to investigate the use of T&CM among cancer patients in Tromsø, and to investigate the differences in T&CM use between people living with cancer, people with cancer previously, and people without a history of cancer. Method Data was drawn from the seventh survey of the Tromsø study conducted in 2015–2016. All inhabitants of Tromsø aged 40 and above were invited to participate (n = 32,591) of whom n = 21,083 accepted the invitation (response rate 65%). Data was collected thorough three self-administered questionnaires and a comprehensive clinical examination. Pearson chi-square tests, Fish...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Patients with diabetes use an increasing number of self-management tools in their daily life. However, health institutions rarely use the data generated by these services mainly due to (1) the lack of data reliability, and (2) medical... more
Patients with diabetes use an increasing number of self-management tools in their daily life. However, health institutions rarely use the data generated by these services mainly due to (1) the lack of data reliability, and (2) medical workers spending too much time extracting relevant information from the vast amount of data produced. This work is part of the FullFlow project, which focuses on self-collected health data sharing directly between patients' tools and EHRs. The main objective is to design and implement a prototype for extracting relevant information and documenting information gaps from self-collected health data by patients with type 1 diabetes using a context-aware approach. The module should permit (1) clinicians to assess the reliability of the data and to identify issues to discuss with their patients, and (2) patients to understand the implication their lifestyle has on their disease. The identification of context and the design of the system relied on (1) 2 w...
Research Interests:
BACKGROUND The prevalence of diabetes and the use of electronic health (eHealth) are increasing. People with diabetes need frequent monitoring and follow-up of health parameters, and eHealth services can be of great value. However, little... more
BACKGROUND The prevalence of diabetes and the use of electronic health (eHealth) are increasing. People with diabetes need frequent monitoring and follow-up of health parameters, and eHealth services can be of great value. However, little is known about the association between the use of eHealth and provider-based health care services among people with diabetes. OBJECTIVE The objective of this study was to investigate the use of 4 different eHealth platforms (apps, search engines, video services, and social media sites) and associations with the use of provider-based health care visits among people diagnosed with type 1 diabetes mellitus (T1DM). METHODS We used email survey data collected from 1250 members of the Norwegian Diabetes Association (aged 18 to 89 years) in 2018. Eligible for analyses were the 523 respondents with T1DM. Using descriptive statistics, we estimated the use of eHealth and the use of general practitioners (GPs) and somatic specialist outpatient services. By lo...
Participatory health approaches are increasingly drawing attention among the scientific community, and could be used for health promotion programmes on diabetes through social media. The main aim of this project is to research how to best... more
Participatory health approaches are increasingly drawing attention among the scientific community, and could be used for health promotion programmes on diabetes through social media. The main aim of this project is to research how to best use social media to promote healthy lifestyles with and within the Norwegian population. The design of the health promotion intervention (HPI) will be participatory, and will involve both a panel of healthcare experts and social media users following the Norwegian Diabetes Association. The panel of experts will agree on the contents by following the Delphi method, and social media users will participate in the definition of the HPI by expressing their opinions through an adhoc online questionnaire. The agreed contents between both parties to be used in the HPI will be posted on three social media channels (Facebook, Twitter and Instagram) along 24 months. The 3 months before starting the HPI, and the 3 months after the HPI will be used as control d...
Research Interests:
The prevalence of diabetes and the use of electronic health (eHealth) resources are increasing. People with diabetes need frequent monitoring and follow-up of health parameters, and eHealth services can be of great significance in this... more
The prevalence of diabetes and the use of electronic health (eHealth) resources are increasing. People with diabetes need frequent monitoring and follow-up of health parameters, and eHealth services can be of great significance in this regard. However, little is known about the extent to which different kinds of eHealth tools are used, and how the use of eHealth is associated with the use of provider-based health care services among people with diabetes. The primary objective of this study is to investigate the use of eHealth and its association with the use of provider-based health care services. The secondary objectives include investigating which eHealth services are used (apps, search engines, video services, social media), the relationship between socioeconomic status and the use of different eHealth tools, whether the use of eHealth is discussed in the clinical encounter, and whether such tools might lead to (or prevent) doctor visits and referrals. We will conduct cross-secti...
Research Interests:
Depression has been identified as one of the most frequent predictors of CAM use. However, limited data exist about the use of CAM providers among people with anxiety/depression in Norway. The aim of this study was to investigate the use... more
Depression has been identified as one of the most frequent predictors of CAM use. However, limited data exist about the use of CAM providers among people with anxiety/depression in Norway. The aim of this study was to investigate the use of CAM providers, and the use of CAM providers and psychiatric outpatient services in combination, among people with self-reported anxiety and/or depression. We used questionnaire data from 12,982 participants (30-87 years) in the cross-sectional sixth Tromsø Study (conducted in 2007-8). Eligible for analyses in our study were 1685 participants who reported suffering from anxiety and/or depression. By descriptive statistical methods, we estimated the use of CAM providers, psychiatric outpatient services, and the combination of these. By logistic regressions we studied the association between the use of these services and gender, age, income, education, and self-reported degree of anxiety/depression. During the previous year, 17.8 % of people with an...