Search

Background: Promotion of healthy behaviour is increasingly highlighted worldwide as a way to improve public health, prevent disease incidence, and decrease long-term costs for healthcare. In Sweden the National Board of Health and Welfare (NBHW) used the well-established format of national guidelines to facilitate a more widespread use of approaches for promotion of healthy lifestyle habits in healthcare. Aims and objectives: The aim of this case study was to explore the tensions between public health knowledge and the tenets of evidence-based medicine (EBM) in the creation of national guidelines on lifestyle habits. Methods: Based on data from interviews with guideline professionals and the collected documents of the national guidelines, we examine how NBHW negotiated the conflicts between public health knowledge and the format of national guidelines. An analytical model based on approaches from the sociology of standardisation is used to explore the ramifications of these negotiations. Findings: In line with findings in the sociology of standardisation, we show how conflicts between public health knowledge and the format of national guidelines result in both having to yield on certain points. This, we claim, results in compromise, but perhaps also compromised notions of validity and causality. Discussion and conclusion: This case offers important learning about the general compatibility of public health and currently dominant methods of EBM. Important crossroads are outlined, concerning how validity and causality are configured in public health guidelines and how these require extensive epistemological deliberation.

Aim: The aim of this study was to describe and evaluate the effect of an individually tailored behavioral medicine treatment in physical therapy, based on a functional behavioral analysis (FBA), for tension-type headache (TTH). Patients and methods: Two case studies with A1-A2-B-A3 design of two patients with TTH was conducted. Outcome variables were headache frequency, headache index (mean intensity), consumption of analgesics, self-efficacy in headache management (Headache Management Self-efficacy Scale [HMSE]), disability, and perceived loss of happiness for activities with family and friends. Results: The results showed that headache frequency and headache index decreased for one of the patients. Self-efficacy in headache management increased markedly for both patients. Conclusion: A behavioral medicine treatment in physical therapy based on an FBA can be a way for physical therapists to handle patients with TTH. Future investigations should focus on large group studies with longer observation periods. [ABSTRACT FROM AUTHOR]