Search

BackgroundResearch on ethnic and socioeconomic treatment differences following in-hospital cardiac arrest (IHCA) largely draws on register data. Due to the correlational nature of such data, it cannot be concluded whether detected differences reflect treatment bias/discrimination – whereby otherwise identical patients are treated differently solely due to sociodemographic factors. To be able to establish discrimination, experimental research is needed.ObjectiveThe primary aim of this experimental study was to examine whether simulated IHCA patients receive different treatment recommendations based on ethnicity and socioeconomic status (SES), holding all other factors (e.g., health status) constant. Another aim was to examine health care professionals’ (HCP) stereotypical beliefs about these groups.MethodsHCP (N = 235) working in acute care made anonymous treatment recommendations while reading IHCA clinical vignettes wherein the patient's ethnicity (Swedish vs. Middle Eastern) and SES had been manipulated. Afterwards they estimated to what extent hospital staff associate these patient groups with certain traits (stereotypes).ResultsNo significant differences in treatment recommendations for Swedish versus Middle Eastern or high versus low SES patients were found. Reported stereotypes about Middle Eastern patients were uniformly negative. SES-related stereotypes, however, were mixed. High SES patients were believed to be more competent (e.g., respected), but less warm (e.g., friendly) than low SES patients.ConclusionsSwedish HCP do not seem to discriminate against patients with Middle Eastern or low SES backgrounds when recommending treatment for simulated IHCA cases, despite the existence of negative stereotypes about these groups. Implications for health care equality and quality are discussed.

Background: Non-shockable initial rhythm is a known risk factor for high mortality at cardiac arrest (CA). However, knowledge on its association with self-reported health in CA survivors is still incomplete. Aim: To examine the associations between initial rhythm and self-reported health in CA survivors. Methods: This nationwide study used data from the Swedish Register for Cardiopulmonary Resuscitation 3–6 months post CA. Health status was measured using EQ-5D-5L and psychological distress by the Hospital Anxiety and Depression Scale (HADS). Kruskal-Wallis test was used to examine differences in self-reported health between groups of different initial rhythms. To control for potential confounders, age, sex, place of CA, aetiology, witnessed status, time to CPR, time to defibrillation, and neurological function were included as covariates in multiple regression analyses for continuous and categorical outcomes. Results: The study included 1783 adult CA survivors. Overall, the CA survivors reported good health status and symptoms of anxiety or depression were uncommon (13.7% and 13.9% respectively). Survivors with PEA and asystole reported significantly more problems in all dimensions of health status (p = 0.037 to p < 0.001), anxiety (p = 0.034), and depression (p = 0.017) compared to VT/VF. Overall, these differences did not remain in the adjusted regression analyses. Conclusions: Initial rhythm is not associated with self-reported health when potential confounders are controlled. Initial rhythm seems to be an indicator of unfavourable factors causing the arrest, or factors related to characteristics and treatment. Therefore, initial rhythm may be used as a proxy for identifying patients at risk for poor outcomes such as worse health status and psychological distress.

Aims: To describe self-reported mental health, bonding with the infant, family wellbeing, and family functioning among mothers and non-birthing parents with children receiving neonatal intensive care and to explore factors associated with bonding with the child, family wellbeing, and family functioning. Methods: This cross-sectional study included families from three different units in Sweden. Parents received a questionnaire that included self-reported measures of the study variables. Results: In total, 75 mothers and 72 non-birthing parents were included. Nearly 40% of the parents reported anxiety symptoms, whereas depression and post-traumatic stress symptoms were uncommon. Mothers reported more mental health issues than non-birthing parents. In the regression analyses depression was associated with problems with bonding and family wellbeing, no other significant associations were identified. Conclusion: Symptoms of anxiety were common but might be a natural and transient reaction. Identifying depression is important to be able to provide targeted family support.

This study aims to investigate the expectations and preferences customers within Generation Z have for service, as well as identify gaps between the expected and actual service. The study will further focus on future challenges for companies regarding service, when Generation Z becomes an increasingly large part of the customer base. The study is based on the following research questions: What kind of customer service do customers want today and what are the gaps? How can customer service develop over time as Generation Z becomes a larger part of the customer base? To answer the study’s research questions, a case study was carried out at FM Mattsson Group using an inductive method and a qualitative research approach. Data were collected through semi-structured interviews at the company’s support department, as well as observations by Generation Z customers on its website. Scientific literature was collected from several sources to contribute to the analysis and interpretation of collected data. The result of the study show that customers expect fast and efficient service, while actual experiences often do not quite meet these expectations. The results highlight that Generation Z customers value smart technology, quick responses, and personalized service regardless of communication channel. As a conclusion, the study highlights need for companies to develop their current customer service strategies to meet Generation Z’s expectations for personalized customer experiences. In addition, the importance of corporate social responsibility and sustainability is also emphasized, values that are of particular importance to Generation Z customers.

There is currently an effort within the European Union and Sweden to make data produced by government agencies available for reuse to citizens and organizations. While Sweden has had a long history of sharing information with its citizens the country is currently behind its northern neighboring countries when it comes to publishing government data openly. In this study, the author seeks to find if there are types of governmental agencies whose work makes it easier or harder to make it available for reuse. This was done in two phases; in the first phase, the author identified overrepresented and underrepresented agency types on Sweden’s open data portal. In the second phase, the author interviewed two agencies from an overrepresented agency type and two agencies from an underrepresented agency type, to learn what has enabled the overrepresented agencies and what has prevented the underrepresented agencies to publish data openly. The results show that agencies that have sensitive data, in general, had a harder time publishing their data openly than those which did not. The agencies that were underrepresented on the Swedish data portal also had decentralized data generation methods and ways of storage that negatively impacted their ability to publish data openly. What enabled the overrepresented agencies to publish data, beyond having a low amount of sensitive data was the tangible benefits of publishing data openly and the organizational willingness that came with these benefits.

Aims Previous research on racial/ethnic disparities in relation to cardiac arrest has mainly focused on black vs. white disparities in the USA. The great majority of these studies concerns out-of-hospital cardiac arrest (OHCA). The current nationwide registry study aims to explore whether there are ethnic differences in treatment and survival following in-hospital cardiac arrest (IHCA), examining possible disparities towards Middle Eastern and African minorities in a European context. Methods and results In this retrospective registry study, 24 217 patients from the IHCA part of the Swedish Registry of Cardiopulmonary Resuscitation were included. Data on patient ethnicity were obtained from Statistics Sweden. Regression analysis was performed to assess the impact of ethnicity on cardiopulmonary resuscitation (CPR) delay, CPR duration, survival immediately after CPR, and the medical team’s reported satisfaction with the treatment. Middle Eastern and African patients were not treated significantly different compared to Nordic patients when controlling for hospital, year, age, sex, socioeconomic status, comorbidity, aetiology, and initial heart rhythm. Interestingly, we find that Middle Eastern patients were more likely to survive than Nordic patients (odds ratio = 1.52). Conclusion Overall, hospital staff do not appear to treat IHCA patients differently based on their ethnicity. Nevertheless, Middle Eastern patients are more likely to survive IHCA.

Objective We studied characteristics, survival, causes of cardiac arrest, conditions preceding cardiac arrest, predictors of survival and trends in the prevalence of COVID-19 among in-hospital cardiac arrest (IHCA) cases. Design and setting Registry-based observational study. Participants We studied all cases (>= 18 years of age) of IHCA receiving cardiopulmonary resuscitation in the Swedish Registry for Cardiopulmonary Resuscitation during 15 March 2020 to 31 December 2020. A total of 1613 patients were included and divided into the following groups: ongoing infection (COVID-19+; n=182), no infection (COVID-19-; n=1062) and unknown/not assessed (n=369). Main outcomes and measures We studied monthly trends in proportions of COVID-19 associated IHCAs, causes of IHCA in relation to COVID-19 status, clinical conditions preceding the cardiac arrest and predictors of survival. Results The rate of COVID-19+ patients suffering an IHCA increased to 23% during the first pandemic wave (April), then abated to 3% in July, and then increased to 19% during the second wave (December). Among COVID-19+ cases, 43% had respiratory insufficiency or infection as the underlying cause of the cardiac arrest, compared with 18% among COVID-19- cases. The most common clinical sign preceding cardiac arrest was hypoxia (57%) among COVID-19+ cases. OR for 30-day survival for COVID-19+ cases was 0.50 (95% CI 0.33 to 0.76), compared with COVID-19- cases. Conclusion During pandemic peaks, up to one-fourth of all IHCAs are complicated by COVID-19, and these patients have halved chance of survival, with women displaying the worst outcomes.