The aim of the study was to highlight the experiences and expectations of Swedish parents with respect to general parental education within child healthcare. Interviews were carried out with 25 parents who had attended education sessions. With a few exceptions the fathers did not take part, and those mothers who did comprised a relatively highly educated group; their views therefore predominate in this study. Socially vulnerable parents such as the unemployed and immigrants took part more sporadically in the meetings, which is why less material is available from these groups. The arrangement and analysis of the material was done using qualitative content analysis. We identified two main categories of importance: ‘parental education content’ and ‘parental education structure’. The parents were on the whole satisfied with the content with respect to the child's physical and psychosocial development. On the other hand, first‐time parents expressed a degree of uncertainty with respect to the new parent roles and parent relation and they thought that the education should place more emphasis on the interplay between the parents and between child and parents. The degree of confidence in the nurse as group leader was mainly high. The parents thought that the groups functioned well socially and were satisfied with the organization of the meetings. They did, however, demand clearer structure and framework with respect to the content. Since the aim of legally established parental education is to improve the conditions of childhood growth and to provide support to parents, it must be considered especially important to provide resources so that the socially vulnerable groups in the community may also be reached.
BackgroundThe Patient Enablement Instrument (PEI), which has been used to evaluate core ingredients in primary care consultations, has been proposed as a means of moving beyond patient satisfaction evaluations. The aim of the present study was to examine the reliability and applicability of the PEI to the Swedish context.MethodsThe original PEI was translated to Swedish and included in a questionnaire that was given to consecutively scheduled patients in four primary care settings. Respondents completed identical questionnaires immediately after a consultation, as well as two days and two weeks later. The analysis focused on internal reliability, test-retest reliability and internal construct validity.ResultsMean PEI scores declined significantly between baseline (3.48, SD 3.21) and the first follow-up questionnaire (3.06, SD 3.37). All three questionnaires showed high internal consistency (Cronbach’s alpha >0.85). Test-retest showed moderate agreement for all questions when comparing baseline and the first follow-up (kappa 0.54-0.65) and greater consistency between the two follow-up questionnaires (kappa 0.65-0.75). A large proportion of respondents characterized at least one of the questions as irrelevant (39%).ConclusionsThe Swedish version of the PEI instrument has high internal consistency and moderate to good reliability. It can be used in research but is not recommended as a measure of quality of care. The instrument could benefit from further development and validity testing.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-015-0242-9) contains supplementary material, which is available to authorized users.
ObjectivesThe optimal treatment of latent autoimmune diabetes in adults (LADA) is not established. We explored whether early insulin treatment, which has shown beneficial effects in rodents and in human pilot studies, would result in better preservation of β-cell function or metabolic control, compared with conventional treatment.Subjects and methodsGlucagon-stimulated C-peptide and HbAlc were evaluated at baseline and after 12, 24 and 36 months in 37 patients recently diagnosed with diabetes, aged ≥30 years, non-insulin-requiring and GADAb and/or ICA positive. Twenty patients received early insulin and 17 received conventional treatment (diet±oral hypoglycaemic agents (OHA), metformin, some and/or sulfonylurea) and insulin when necessary.ResultsLevel of metabolic control, HbAlc, was preserved in the early insulin treated, while it significantly deteriorated in the conventionally treated. There was no significant difference between the groups in C-peptide after 12, 24 or 36 months, or in the decline of C-peptide. Only baseline C-peptide predicted a C-peptide of ≥0.5 nmol/l at 36 months. Gender, body mass index, antibody titres or HbAlc did not influence the levels of C-peptide or HbAlc at baseline or end-of-study, or the decline in C-peptide. Among the diet±OHA-treated, 5/17 (30%) developed insulin dependency during the follow-up. No major hypoglycaemic events occurred.ConclusionsEarly insulin treatment in LADA leads to better preservation of metabolic control and was safe. Superior preservation of C-peptide could not be significantly demonstrated. Only baseline level of C-peptide significantly influenced C-peptide level after 3 years. Further studies exploring the best treatment in LADA are warranted.
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