This study analyzes the semiotic resources in two versions of Vårdguiden's web text about tick bites: one longer version and one in easy Swedish. The aim is to identify and compare the prior knowledge and information need of each versions' model reader. This study is theoretically grounded in social semiotics and health literacy. The method consists of three multimodal text analyzes with ideational, interpersonal and textual sub-analyses.  Both versions presupposing several actual, practical and mental prior knowledge of the model reader. The information need of the versions' model reader is both common and separate. Both versions also presupposing that the model reader needs informing, explanatory, instructive and reassuring messages with a multimodal and multi-sequential presentation. The longer version presupposes more comprehensive prior knowledge and larger information needs. The version in easy Swedish though presupposes some prior knowledge which is not assumed in the longer version. For example, it is prior knowledge of how a tick bite looks like and the prior knowledges which is required when photographic close-ups should be interpreted. The version in easy Swedish also and presupposes larger needs for explanations and instructions. The results hinting what the versions presuppose of the empirical reader and prompting a discussion about how the versions high demands for health literacy can impede the reader friendliness. However, the results show that the versions' design creates possibilities for broad groups to assimilate the content. The study highlights some important challenges which are relevant when texts should be adapted to broad groups. / I studien analyseras två versioner av 1177 Vårdguidens text om fästingbett: en längre version och en version på lätt svenska. Syftet är att identifiera och jämföra de förkunskaper och behov av information som förutsätts hos versionernas modelläsare. Studien är teoretiskt grundad i sociosemiotik och hälsolitteracitet. Metoden består av tre multimodala textanalyser med ideationella, interpersonella och textuella delanalyser. Båda versionerna förutsätter flera faktiska, praktiska och mentala förkunskaper hos modelläsaren. Behoven av information hos versionernas modelläsare är dels gemensamma, dels skilda. Båda versionerna förutsätter att modelläsaren behöver informerande, förklarande, instruerande och lugnande budskap som presenteras multimodalt och multisekventiellt. Den längre versionen förutsätter mer omfattande förkunskaper och större behov av information. Versionen på lätt svenska förutsätter dock några förkunskaper som inte förutsätts i den längre versionen. Det är till exempel förkunskaper om hur ett fästingbett ser ut och de förkunskaper som krävs för att kunna tolka fotografiska närbilder. Versionen på lätt svenska förutsätter även att modelläsaren behöver fler förklaringar och instruerande budskap. Resultaten antyder vad versionerna förutsätter hos de empiriska mottagarna och föranleder en diskussion om hur versionernas höga krav på hälsolitteracitet kan hindra brukarvänligheten. Resultaten visar dock att versionernas utformning ger möjligheter för breda grupper att tillgodogöra sig innehållet. Studien belyser några viktiga utmaningar som är relevanta när texter ska mottagaranpassas till breda grupper. / <p>Uppsatsen ingår i kursen språkrådgivning och textvård magisterkurs, 30 hp.</p>

Introduktion: Den sexuella hälsan kan förslagsvis främjas genom insatser som en god sexualundervisning. Skolan har ingen kursplan i sexualitet, samtycke och relationer vilket medför att skillnaden på sexualundervisningen i Sveriges skolor är stor vilket kan leda till riskfyllda sexualvanor, fler partners och låg kondomanvändning.  Syfte: Det primära syftet var att undersöka hur människor upplever den nuvarande sexualundervisningen i skolan. Det sekundära syftet var att ta fram ett konkret material som skolväsendet kan använda för att kunna bedriva en hälsofrämjande sexualundervisning för barn och unga.  Metod: En empirisk kvantitativ enkätstudie har tillämpats. En webbenkät lades ut på Facebook och resultatet sammanställdes i Google Forms. Sen användes enkätresultaten från denna studie tillsammans med resultat från tidigare studier som har granskats i samband med detta arbete för att skriva en kursplan.  Resultat: 51 stycken respondenter svarade på enkäten i åldrarna 20-41 år. Majoriteten av respondenterna upplevde att de inte var nöjda med den sexualundervisning de har fått. Många av respondenterna uppgav att samtliga ämnen inte har tagits upp i tillräckligt stor utsträckning och många upplevde att de inte hade tillräckligt med information i dessa ämnen. 1 av 3 tyckte att undervisningen saknade en övergripande kvalitet och flertalet lyfte att de saknade en behörig lärare.  Diskussion: En möjlighet är att den sexuella hälsan blir lidande av den bristfälliga undervisningen i form av att eleverna missar tillfällen att utveckla empowerment och säkerhet kring sin sexualitet och identitet. En kursplan i sexualitet, samtycke och relationer kan skapa en ökad trygghet hos lärarna vilket också ökar kvaliteten på undervisningen. Ett förslag är att universitetsstudenter som har kompetens inom detta område, exempelvis studenter på sjuksköterskeprogrammet, hälsovägledarprogrammet eller andra studenter inom andra relevanta utbildningar, undervisar studenter på grundskolenivå som en del av båda parters utbildning. / Introduction: Sexual health can be promoted through initiatives such as good sex education. The school has no curriculum in sexuality, consent and relationships, which means that the difference in sexuality education in Sweden's schools is large, which can lead to risky sexual habits, more partners and low condom use. Purpose: The primary purpose was to investigate how people experience the current sex education in school. The secondary aim was to produce concrete material that the school system can use to be able to conduct health-promoting sex education for children and young people. Method: An empirical quantitative survey study has been applied. A web survey was posted on Facebook and the results were compiled in Google Forms. The survey results from this study were then used together with results from previous studies that have been reviewed in connection with this work to write a course plan. Results: 51 respondents answered the survey aged 20-41. The majority of respondents felt that they were not satisfied with the sex education they have received. Many of the respondents stated that all topics have not been covered to a sufficient extent and many felt that they did not have enough information on these topics. 1 in 3 thought that the teaching lacked an overall quality and the majority pointed out that they lacked a qualified teacher. Discussion: One possibility is that sexual health suffers from the inadequate teaching in the form of students missing opportunities to develop empowerment and security around their sexuality and identity. A curriculum in sexuality, consent and relationships can create increased security among teachers, which also increases the quality of teaching. One suggestion is that university students who have competence in this area, for example students in the nursing program, the health guidance program or other students in other relevant educations, teach students at primary school level as part of both parties' education.

No description available.

To address emerging challenges in empowering patients through telehealth, this dissertation has the following objectives: (a) find the key characteristics that enable patient empowerment [PE], (b) determining when will PE work as a solution, (c) find the optimal telehealth care method that enables PE, and (d) evaluate the impact of telehealth on health care outcomes (such as, patient satisfaction, patient trust with primary care providers, etc.) that ultimately enhances PE. These objectives are addressed in three studies presented here as three essays. Collectively, these essays contribute to the knowledge on PE, patient trust, and telehealth by providing insights on leveraging PE towards better health care services and delivery systems. Essay 1 aims to systemically map the concept of PE using principles of systems thinking with the Boardman soft systems methodology that enables a graphical visualization (i.e., systemigrams). Essay 2 investigates the practical and theoretical implications of connecting patients to empowerment care plans and minimizing wait times in healthcare service delivery using electronic prescriptions (s-scripts), phone calls, and video calls. In Essay 3, the mediating role of telehealth services between patient empowerment and patient satisfaction was analyzed, along with patient trust was assessed as a moderator between telehealth usability and patient satisfaction. Two hundred sixty-two responses from patients in North America with chronic illnesses were collected through an online survey questionnaire were analyzed using partial least squares-structural equation modeling (PLS-SEM). The findings of the research show that patients with chronic illnesses in North America feel empowered by using telehealth as they can get diagnosis of the illness even in remote areas and face no obstacle.

The thesis provides a comprehensive overview of key issues affecting practice, policy and patients, in current efforts for colorectal cancer (CRC) disease control. The global burden of CRC is expected to increase by 60% to more than 2.2 million new cases and 1.1 million deaths by 2030. CRC incidence and mortality rates vary up to 10-fold worldwide, which is thought to reflect variation in lifestyles, especially diet. Better primary prevention, and more effective early detection, in screening and surveillance, are needed to reduce the number of patients with CRC in future1. The risk factors for CRC development include genetic, behavioural, environmental and socio-economic factors. Changes to surveillance, which offer non-invasive testing and provide primary prevention interventions represent promising opportunities to improve outcomes and personalise care in those at risk of CRC. By systematic review of the literature, I highlight the gaps in comparative effectiveness analyses of post-polypectomy surveillance. Using micro-simulation methods I assess the role of non-invasive, faecal immunochemical testing in surveillance programmes, to optimise post-polypectomy surveillance programmes, and in an accompanying sub-study, I explore the value of adding an adjunct diet and lifestyle intervention. The acceptability of such revisions is exposed to patient preference evaluation by discrete choice experiment methods. These preferences are accompanied by evidence generated from the prospective evaluation of the health literacy, numeracy, sedentary behaviour levels, body mass index (BMI) and information provision about cancer risk factors, to highlight the potential opportunities for personalisation and optimisation of surveillance. Additional analysis examines the optimisation of a screening programme facing colonoscopy constraints, highlighting the attendant potential to reduce costs and save lives within current capacity.

This research examines the relationship between health literacy among End Stage Renal Disease (ESRD) patients and its relevance for communication between patients and providers. The study was conducted among dialysis services providers at the Good Samaritan Dialysis Center and dialysis patients receiving care at the Center. Data collection techniques included individual interviews, surveys, and the Short Test of Functional Health Literacy in Adults (S-TOFHLA), which measured the health literacy level of the participants. The results of the study show that a large majority of the patients have "adequate" health literacy, which contradicts the provider's perceptions of the patient's ability to comprehend health information. Provider's perspectives are shaped by their training and work environment. The study suggests that structural barriers and communication issues impede effective patient-provider interactions. This issue is especially serious for those chronic disease patients who have limited self-management skills. / Graduation date: 2012

Adolescent perspectives on health and the social and literate values of their health related behaviours require exploration and examination in health literacy, as knowledge gaps related to the constituents of health literate practices, and the functions and acquisition of health literacy exist in the literature. Research addressing this was approached based on socio-cultural and socio-ecological principles using a collective instrumental case design. Participants were new adolescent mother aged 15-18 recruited from 4 different community/education programs around Victoria, BC. Data was collected over a four month period, and consisted of individual and focus group interviews, journals, and researchers’ observations and field notes. Findings show that participants’ health behaviours changed significantly in tandem with their identities, the groups they associated with, and the social contexts they moved within. Findings indicate that identity, informal social environments, and unconscious cognitive process and psychosocial needs play a role in adolescents health literacy and literate practices.

Sammanfattning Syftet med studien är att undersöka vilka variabler som påverkar lärares syn på hälsa och på så sätt också hälsoundervisningen inom ämnet idrott och hälsa. Frågeställningarna är: Vilken är lärares syn på hälsa? Vilken är lärares syn på hälsa, kopplat till ämnet idrott och hälsa? Hur undervisar lärarna om hälsa inom ämnet idrott och hälsa? Påverkar kön, ålder och erfarenhet lärares syn på hälsa och slutligen hälsoundervisningen? Metod Studiens metod är en enkätundersökning som riktas mot undervisande lärare i ämnet idrott och hälsa. Den utformades som en webbenkät som sedan publicerades via en sluten facebookgrupp vid namn Idrottslärare, samt skickades ut till samtliga grund- och gymnasieskolor i Stockholm. Av de tillfrågade valde 340 lärare i idrott och hälsa att delta i studien. Som teoretisk utgångspunkt och som analys av empirin valdes Antonovskys teorier: Känslan av sammanhang (KASAM) och det patogena och salutogena perspektiven på hälsa. Resultat Samtliga deltagare i studien anser att hälsa främst är fysiskt. De yngre deltagarna anser däremot att hälsa är mer holistiskt, salutogent, samt att psykiska och sociala aspekter av hälsa värdesätts högre hos yngre än hos äldre. Kvinnor och äldre har generellt en mer patogen syn på hälsa och fokuserar mer på riskfaktorer. Dessa resultat gäller för både den generella synen av hälsa och synsättet inom ämnet idrott och hälsa. Vad gäller undervisningen i hälsa så är yngre lärare mer benägna att låta eleverna vara delaktiga i undervisningen än äldre. De äldre lärarna är istället mer angelägna att planera sin undervisning inom ämnet, men är även mindre benägna att ändra den efter skilda erfarenheter hos klasser och elever. Slutsats Variablerna kön, ålder och erfarenhet påverkar lärares syn på hälsa, samt hur undervisningen bedrivs inom ämnet. Lärares bakgrund påverkar alltså i slutändan undervisningen i idrott och hälsa.

N世代青年族群是開始以網路為主，資訊傳遞翻轉的新興世代，本研究藉由資訊-動機-行為技能模式（簡稱IMB模式）瞭解影響青年族群正確用藥行為的因子，探討青年族群醫藥素養、個人態度、用藥自我效能、行為障礙感知、醫藥傳播資訊暴露程度及正確用藥行為的發展現況，藉此發現喚起病人或家屬對病人安全及醫療風險認知的切入點，並增加警覺及主動積極性行為，與醫藥人員共同合作。為自己的健康狀態把關。 本研究所採用的方法是網路問卷調查，針對1977年到1997年出生的N世代青年族群蒐集資料，共獲得1,198份有效問卷。 本研究發現青年族群整體的用藥行為偏向經常做到，其中實踐程度由高至低依序為堅持正當藥品取得方式、主動告知身體狀況、看清楚用藥標示和主動諮詢專業。青年族群九成九以上有高醫藥素養，有六成以上的受訪者得到滿分。大部分青年族群偏向「同意」有正向的用藥態度；自我效能整體的認同度偏向於「同意」。受訪者對於用藥行為障礙感知程度整體偏向「不同意」有用藥行為障礙。 多數青年從媒體獲得醫藥資訊的頻率偏向「每月1~2次」為主。整體面向暴露由高至低為專業管道、傳統大眾媒體及新興網路。青年族群前三大醫藥資訊暴露管道依序為Facebook、電視、醫護人員，而BBS、大眾運輸工具看板、海報、傳單、宣傳手冊、產品包裝等是接著依序常用的管道。 醫藥素養只對堅持正當藥品取得方式有統計顯著正向預測力。個人態度和自我效能與用藥行為的四項依變項主動告知身體狀況、看清楚用藥標示、堅持正當藥品取得方式和主動諮詢專業，在相關分析及階層複迴歸分析都顯示有統計顯著正向相關。行為障礙感知與用藥行為的四項依變項主動告知身體狀況、看清楚用藥標示、堅持正當藥品取得方式和主動諮詢專業，在相關分析及階層複迴歸分析都顯示有統計顯著負向相關。 傳統大眾媒體與主動告知身體狀況、看清楚用藥標示和主動諮詢專業，在相關分析顯示有統計顯著正向相關，但階層複迴歸分析都未有統計顯著預測力；堅持正當藥品取得方式在相關分析及階層複迴歸分析都是顯著負向相關。新興網路與主動告知身體狀況和主動諮詢專業，在相關分析及階層複迴歸分析顯示都有統計顯著正向相關；新興網路與看清楚用藥標示，在相關分析顯示有統計顯著正向相關，但階層複迴歸分析未有統計顯著預測力；新興網路與堅持正當藥品取得方式在相關分析及階層複迴歸分析都是顯著負向相關。專業管道與主動告知身體狀況、看清楚用藥標示和主動諮詢專業，在相關分析及階層複迴歸分析顯示都有統計顯著正向相關；專業管道與堅持正當藥品取得方式在相關分析是顯著負向相關，但階層複迴歸分析中是無統計顯著預測力。 本研究的主要貢獻是證實藉由IMB模式的各項因子，都能有效預測部分或全部的正確用藥行為，尤其是個人態度、自我效能及行為障礙感知這三面向，並且呼應行為技能是影響行為的重要關鍵。因此往後如果有醫藥行為要推廣或宣傳時，就可以藉助IMB模式的因子為原型、大綱，相信會有更好的效果產生，也希望有人可以做後續相關研究，證實IMB模式的可行性。 / The Net Generation is the first generation to grow up in the digital world. The goal of this study is to understand the medical behavior of the Net Generation using the information-motivation-behavioral skills (IMB) model and the conditions of health literacy, personal attitudes, medical self-efficacy, the perception of behavioral barriers, the level of media exposure and medical behavior. To emphasize patient safety and medical risks, we tried to find the way to improve the awareness and active behavior to cooperate with medical professionals and to maintain self-health. The 1,198 effective samples were collected from people who were born between 1977 and 1999 through a web questionnaire. The study found that the Net Generation usually had correct medication-taking behavior. The frequency of the behavior from high to low was obtaining medicine through official channels, actively telling self-conditions, clearly reading medication labels, and actively consulting medical professionals. Over 99% of the participants had high health literacy and over 60% got full scores. Most of the participants tended to agree that they had positive personal attitudes and self-efficacy but disagreed they had the perception of behavioral barriers. Most of the participants obtained medical information through media once or twice a month. The exposure to media from high to low was professional channels, traditional mass media, and internet. The exposure to media channels in order were: Facebook, television, medical professionals, BBS, public transportation boards, and advertising brochures. Health literacy could only positively predict actively telling self-conditions. Personal attitudes and self-efficacy could positively predict four dependent variables of correct medication-taking behavior including obtaining medicine through official channels, actively telling self-conditions, clearly reading medication labels, and actively consulting medical professionals. And, the perception of behavioral barriers could negatively predict them. There were some statistically positive correlations between traditional mass media and correct medication-taking behavior including actively telling self-conditions, clearly reading medication labels, and actively consulting medical professionals. However, there was no prediction in hierarchical regression. There was a statistically negative correlation in Pearson’s correlation and hierarchical regression between traditional mass media and obtaining medicine through official channels. There were statistically positive correlations in Pearson’s correlation and hierarchical regression between internet and actively telling self-conditions or actively consulting medical professionals. However, there was a statistically negative correlation between internet and obtaining medicine through official channels. There was a statistically positive correlation between the internet and clearly reading medication labels but there was no prediction in hierarchical regression between them. There were statistically positive correlations in Pearson’s correlation and hierarchical regression between professional channels and actively telling self-conditions, clearly reading medication labels, or actively consulting medical professionals. There was a statistically negative correlation between professional channels and obtaining medicine through official channels but there was no correlation in hierarchical regression. The main contribution of this study was to support the argument that the IMB model could predict correct medication-taking behavior, especially when personal attitudes, self-efficacy and the perception of behavioral barriers are looked at. Therefore, behavioral skills were the key to correctly using medication. If someone wants to do medical behavior promotions, then the concept of the IMB model could be very effective.

The overall aim of this thesis was to examine the distribution of health literacy (HL) levels in newly arrived Arabic-, Dari-, or Somali-speaking refugees in Sweden. Further aims were to investigate sociodemographic characteristics associated with inadequate HL in this group, and to investigate whether HL levels are associated with experiences of the health examination for asylum seekers (HEA), health seeking behaviour and health. Three quantitative cross-sectional studies, using data from two different surveys, were conducted among Arabic-, Dari-, and Somali-speaking, newly arrived refugees taking part in courses in Swedish for immigrants or civic orientation. In addition, an explorative qualitative study, based on focus group discussions, was performed on Arabic- and Somali-speaking newly arrived refugees who had taken part in an HEA. All data were collected 2013-2016. The quantitative data were analysed using different statistical methods, foremost descriptive statistics and univariate and multivariate binary logistic regression analyses. The qualitative data were analysed using Graneheim and Lundman’s method for latent content analysis. The main findings were that the majority of Arabic-, Dari-, or Somali-speaking refugees in Sweden have limited functional health literacy (FHL) and/or limited comprehensive health literacy (CHL). Having a low education level and/or being born in Somalia were associated with having inadequate FHL, but not with having inadequate CHL. Limited FHL was associated with inadequate CHL. Experiences of poor quality of communication and having benefited little from the HEA were more common among those with limited CHL, as compared to those with higher CHL. Experiences of communication problems and a lack of information related to the HEA were found in the qualitative studies as well. In addition, it was more common that those with limited CHL reported poor general health and impaired psychological well-being, and that they had refrained from seeking healthcare. In conclusion: limited HL is common among newly arrived refugees in Sweden and seems to be of importance for the experience of the HEA, health-seeking behaviour and health. HL needs to be taken into consideration in the work with refugees in order to increase equity in healthcare and health.