Scandinavian Journal of Public Health最新文献

Aims: In Nordic countries, the influx of immigrant doctors and nurses has been increasing since 2005, however retention remains a challenge. The aims of this scoping review were to examine the facilitators and barriers to the retention of immigrant doctors and nurses in the Nordic countries in order to inform future studies and interventions.

Method: A scoping review of peer-reviewed studies focusing on the retention of immigrant doctors and nurses in the Nordic countries was conducted using the framework developed by Arksey and O'Malley. In total, 37 studies were included. The analysis entailed both a numerical analysis to provide a descriptive view of frequencies and a thematic analysis utilising Pierre Bourdieu's concepts of field, capital, habitus and doxa.

Results: Facilitators for retaining immigrant doctors and nurses encompassed a sense of belonging, support from management and peers, collegiality, acknowledgement of diverse cultural competencies and the establishment of relevant professional networks. Barriers included unfamiliarity with local healthcare systems, discrimination, inadequate support in entry-level positions, poor psychosocial work environments, and limited professional networks. Few studies focused on the facilitators for retaining immigrant doctors or nurses, few examined the social and economic costs of immigration, and hardly any addressed the processes related to licencing, authorisation and accreditation.

Conclusions: The majority of the included studies framed immigrant doctors and nurses as challenges to management or the medical labour market. The findings indicated a need for a more comprehensive and inclusive approach to health workforce management across the Nordic countries to accommodate the increasingly diverse workforce in terms of international migratory backgrounds.

Aims: Reproductive history conveys information about potential health risks later in adulthood. This study aimed to examine the validity of self-reported number of pregnancies and maternal age at first birth (AFB) among females attending BreastScreen Norway.

Methods: Participants were identified through the Janus Serum Bank cohort in Norway and were eligible for this cross-sectional validation study if they participated in a health survey issued by BreastScreen Norway between 2006 and 2015. Retrospective self-reported survey information on number of pregnancies and AFB in years was validated against prospectively collected information from the Medical Birth Registry of Norway (MBRN) using the Spearman rank (r_s) and intraclass correlation coefficients (ICC) with 95% confidence intervals (CI).

Results: After exclusions, 51,598 subjects were included in the analysis on number of pregnancies and 46,919 in the analysis on AFB. On average, study subjects were 59-60 years old when completing the health survey and had become first-time mothers roughly 36 years earlier. Survey-based information about number of pregnancies was highly correlated and demonstrated high agreement with the registry data (r_s=0.967, 95% CI 0.964-0.969; ICC=0.884, 95% CI 0.882-0.885). Survey-based information about AFB demonstrated even higher correlation and very high agreement with the registry data (r_s=0.975, 95% CI 0.973-0.976; ICC=0.974, 95% CI 0.974-0.975).

Conclusions: Retrospectively recalled survey-based information about number of pregnancies and AFB was highly accurate when validated against prospectively collected information in the MBRN. These survey-based data are valuable for future epidemiological research, and linkage to the MBRN may not be required when these data are available.

Background: Effective public health initiatives should be founded on a comprehensive and robust understanding of health-related factors including societal and community contexts. The Norwegian Counties Public Health Survey (NCPHS) aims for insights into the adult population on topics relevant for planning public health practices at county and municipality levels.

Methods: The NCPHS includes a core questionnaire on public health-related topics and demographics, including indicators of socio-economy, with additional optional questions and scales varying across data collections. Samples are drawn from the Norwegian National Population Register and 'washed' against the Common Contact Register to retrieve digital contact information and exclude those who cannot be contacted electronically. NCPHS was piloted in 2015 and 2018 (four counties). After some revision of instruments and sampling procedures, surveys have been carried out in most Norwegian counties since 2019. The total number of participants has now passed 400,000.

Results: Expedient data analysis has enabled the Norwegian Institute of Public Health to present comprehensive reports within 6 weeks of completed data collections. In these, outcome variables are analysed against district (within counties), gender, age, educational attainment and self-reported sufficiency of household income. Tables are also made available at the municipality level.

Conclusions: The NCPHS represents a valuable addition to existing data sources, providing critical information for planning purposes for local and regional public health authorities, for assessing trends over time, comparisons across counties and regions and for evaluation of policies and interventions. The value of such a system during times of crisis was demonstrated during the COVID-19 pandemic.

Aims: This study examines the evidence for similar increases in psychosomatic complaints among 15-year-olds in the Nordic countries over the period 2002-2022. A distinction is made between the level and shape of these time trends.

Methods: A dataset from the Health Behaviour in School-aged Children survey from 2002 to 2022 was used. Time trends for psychosomatic complaints were analysed for five Nordic countries: Denmark, Finland, Iceland, Norway and Sweden.

Results: A significant increase in psychosomatic complaints over the last two decades was found among 15-year-old boys and girls in all countries, especially among girls. The shapes of the time trends were very similar for adolescents in all Nordic countries. There were significant differences in the time trends between the countries. Here, the countries with high or low levels of psychosomatic complaints in 2022 were largely the same as those with high or low levels of psychosomatic complaints years earlier.

Conclusions: The high degree of similarity observed in the shapes of the time trends for psychosomatic complaints among Nordic adolescents, as evidenced by this study, suggests that explanations for the observed increases in these psychosomatic complaints should be sought in conditions common to the five countries. However, country-specific explanations are more likely to be candidates for understanding differences in the levels of these time trends. The potential for differentiation between shapes and levels using the aggregate technique when comparing countries also provides an opportunity to empirically examine country-general and country-specific explanations for trends in measures in other areas of research.

Aims: This study aimed to evaluate Norwegian elder abuse prevention policies using the Toronto Declaration's framework, focusing on policy agenda configuration, development, and political processes. It sought to identify gaps and propose recommendations for enhancing policy coherence and effectiveness.

Methods: The analysis employed John W. Kingdon's Multiple Streams Framework and document analysis to assess the current state of elder abuse prevention policies. Stakeholder interviews provided insights into implementation challenges and opportunities for policy enhancement.

Results: The study revealed that while Norwegian policies have progressed, significant gaps remain in public awareness, legal enforcement, service accessibility, and systematic data collection. Notably, there is an absence of specific elder abuse legislation. Stakeholder interviews highlighted challenges in policy implementation and suggested areas for improvement.

Conclusions: The findings underscore the need for specialized legislation to better protect older adults. Recommendations include increasing public awareness, enhancing legal frameworks, improving service accessibility, and establishing systematic data collection mechanisms. These measures are crucial for advancing policy coherence and effectiveness in elder abuse prevention.

Aims: To identify associations between chronic conditions and eight key health risks (stress, loneliness, sleep, obesity/body mass index, smoking, exercise, alcohol consumption, and fruit intake) and provide a practical descriptive profile of the distribution of health risks within chronic conditions.

Methods: The sample involved 56,988 Danish residents aged over 16 years from three national health surveys (2010/2013), one sociodemographic register, and seven national health registers. Linear and logistic regression models adjusting for socioeconomic variables were used to analyse associations with 14 disease groups and 30 common conditions.

Results: The regression analyses revealed that stress, obesity, and physical inactivity were the most consistently associated health risk factors across disease groups. We identified three groups of health risks with similar strengths of associations. Firstly, one group comprising obesity, stress, and sleep troubles, was significantly linked to 27, 23, and 22 chronic conditions, respectively. Secondly, a group of physical inactivity/loneliness showed moderate associations, linked to 19 and five chronic conditions, particularly mental health conditions; and thirdly, a group of smoking, drinking, and low fruit intake showed the weakest and fewest associations. A descriptive profile showed that anxiety, schizophrenia, attention deficit hyperactivity disorder, headaches and chronic obstructive pulmonary disease were conditions with high proportions of patients experiencing more than four health risks.

Conclusions: The current study provides comparable, hierarchical information on the strength of associations between eight health risks and chronic conditions adjusted for socioeconomic factors. The findings suggest that healthcare professionals, policymakers and public health strategies should place less emphasis on classic behavioural health risks such as smoking and more attention on psychological factors such as stress, sleep problems, and loneliness.

Aim: Identifying disability among children in surveys is important for improving public health initiatives. However, this process is challenging, as different measurement approaches and cut-offs impact prevalence rates. This study aims to assess disability using non-relational and relational models with different cut-offs to reveal the differences in prevalence, and to examine differences in life satisfaction between children with and without disabilities based on the varying measures.

Method: This cross-sectional study used data from 6049 Norwegian children (10-13 years). We assessed non-relational disability using Washington Group questions about functional limitations. We additionally measured perceived barriers in school and leisure for those who reported functional limitations, to assess disability according to the relational model. Different cut-offs were applied for both measures. Linear regression analysis was used to investigate differences in life satisfaction between children with and without disabilities for all measures.

Results: Disability prevalence rates were lower under the relational model compared to the non-relational model across all cut-offs, indicating that many children who were identified as disabled in the non-relational model do not experience hindrances in school or leisure. For example, with the 'often or more' cut-off, the non-relational model showed a 27.6% prevalence, while the relational model showed 8.2%. Life satisfaction was significantly lower among children with disabilities compared to their peers without disabilities, with larger differences observed when using the relational model.

Conclusions: Assessing disability through the relational model provides a nuanced understanding of disability by emphasising societal barriers. Incorporating perceived hindrances in children's daily lives offers valuable insights for public health initiatives and policy making.

Aims: This study provides an off-the-shelf catalogue of prevalence rates of eight health-related risk factors (self-perceived stress, loneliness, sleep quality, obesity/body mass index, smoking, physical exercise, alcohol consumption, and fruit intake) for 199 chronic conditions, disease groups and socioeconomic covariates in Denmark.

Methods: The study population comprised a randomised sample of Danish residents aged 16 years and older (n=56,988). Data were derived from a linkage of three national health surveys (2010, 2013) and seven national health and sociodemographic registers. Means and prevalence rates, including sex and age-standardised estimates, were presented.

Results: The most prevalent health risks were insufficient fruit intake (93.8%), most stressed quartile (20.5%), smoking daily (17.2%), physical inactivity (16.6%), obesity (15.0%), very bothered by sleep (9.7%), drinking more than recommended (8.7%), and 'often feels lonely' (5.5%). Chronic conditions with the highest mean numbers of health risks were mental disorders (disease group F; mean = 2.6), diseases of the digestive system (K; mean = 2.2), neurological diseases (G; mean = 2.1), musculoskeletal-related diseases (M; mean = 2.0), and respiratory-related diseases (J; mean = 1.9). In comparison, people without a chronic condition had a mean of 1.6 health risks. Marked socioeconomic disparities were also observed, with more risks among groups with lower education and income.

Conclusions: The nationally representative off-the-shelf catalogue provides essential information on eight common health risks across 199 chronic conditions and socioeconomic groups. The findings offer a resource for differentiated healthcare planning, prevention, and research.

Background: Healthcare professionals often face tension between caregiving values and systemic demands for efficiency and economic stability. While caregivers focus on patient well-being, hospital leaders must ensure resource and staff management-roles that can appear contradictory.

Objective: This study explores how both caregivers and leaders in a large Norwegian hospital experience meaning in their work, aiming to identify shared ground for healthcare engagement. Drawing on Hartmut Rosa's resonance theory and Tatjana Schnell's research on meaning in life, we examine how professional experiences foster or hinder resonance-a mode of being characterized by mutual responsiveness and transformation.

Methods: Twelve semi-structured interviews were conducted with nurses, doctors, and leaders using a guide informed by resonance theory. Data were analyzed thematically in a multidisciplinary team.

Results: Four themes emerged: (1) healthcare as a demanding yet meaningful profession, (2) organizational challenges, (3) patient relationships, and (4) teamwork and collegial support. Across roles, participants described systemic pressures that threaten meaningful engagement, but also highlighted moments of deep resonance-particularly in patient care, collaboration, and learning.

Discussion: Resonance and meaning are sustained when work aligns with moral purpose and supports relational and reflective engagement. Both caregivers and leaders seek meaning in their roles, often through shared values and relationships. These findings underscore the need for organizational structures that allow space for resonance, rather than accelerating alienation through excessive control and restructuring.

Conclusions: Caring for meaning represents common ground for caregivers and leaders. A resonance-informed healthcare leadership might strengthen both staff well-being and quality of care.

Aims: We use cognitive tests among military conscripts in Norway to further investigate an association between the Chernobyl fallout and mathematical skills previously reported for school grades both in Norway and in Sweden.

Methods: The Medical Birth Registry of Norway was linked with data from the Norwegian Armed Forces Health Registry on conscript cognitive scores. Average radiation doses were estimated for each municipality and calendar month from May 1986 to April 1989. Dose in the mother's residential municipality in the fifth calendar month of the pregnancy was used as exposure. Total cognitive score among boys was analysed using a natural-experiment design with pregnancy cohorts from years prior to the fallout as reference. Our analysis estimated whether a difference in scores before and during exposure was specific to regions with higher doses. Sub-scores for numerical reasoning were available only for cohorts after 1986. An alternative sibship analysis using younger brothers as reference was therefore performed.

Results: We found no evidence of reduced total cognitive score in areas with relatively higher average radiation doses. Similarly, there was no evidence that numerical reasoning was reduced.

Conclusions: Our analyses did not identify associations between the Chernobyl radioactive fallout in Norway and cognitive abilities, including mathematics skills, among conscripts exposed in utero. Incomplete participation in conscript testing and the possibility of selection bias is a limitation, although conscript participation was not associated with exposure. Differential time trends in cognitive scores in the study period between areas with higher and lower doses may have biased our analysis.