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      Impact of telephone nursing education program for equity in healthcare

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          Abstract

          Background

          The Swedish Healthcare Act prescribes that healthcare should be provided according to needs and with respect for each person’s human dignity. The goal is equity in health for the whole population. In spite of this, studies have revealed that Swedish healthcare is not always provided equally. This has also been observed in telephone nursing.

          Therefore, the aim of the present study was to investigate if and how an educational intervention can improve awareness of equity in healthcare among telephone nurses.

          Methods

          The study had a quasi-experimental design, with one intervention group and one control group. A base-line measurement was performed before an educational intervention and a follow-up measurement was made afterwards in both groups, using a study specific questionnaire in which fictive persons of different age, gender and ethnicity were assessed concerning, e.g., power over one’s own life, quality of life and experience of discrimination. The educational intervention consisted of a web-based lecture, literature and a seminar, covering aspects of inequality in healthcare related to gender, age and ethnicity, and gender and intersectionality theories as explaining models for these conditions.

          Results

          The results showed few significant differences before and after the intervention in the intervention group. Also in the control group few significant differences were found in the second measurement, although no intervention was performed in that group. The reason might be that the instrument used was not sensitive enough to pick up an expected raised awareness of equity in healthcare, or that solely the act of filling out the questionnaire can create a sort of intervention effect. Fictive persons born in Sweden and of young age were assessed to have a higher Good life-index than the fictive persons born outside Europe and of higher age in all assessments.

          Conclusion

          The results are an imperative that equity in healthcare still needs to be educated and discussed in different healthcare settings. The intervention and questionnaire were designed to fit telephone nurses, but could easily be adjusted to suit other professional groups, who need to increase their awareness of equity in healthcare.

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          Most cited references43

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          Constructions of masculinity and their influence on men's well-being: a theory of gender and health.

          Men in the United States suffer more severe chronic conditions, have higher death rates for all 15 leading causes of death, and die nearly 7 yr younger than women. Health-related beliefs and behaviours are important contributors to these differences. Men in the United States are more likely than women to adopt beliefs and behaviours that increase their risks, and are less likely to engage in behaviours that are linked with health and longevity. In an attempt to explain these differences, this paper proposes a relational theory of men's health from a social constructionist and feminist perspective. It suggests that health-related beliefs and behaviours, like other social practices that women and men engage in, are a means for demonstrating femininities and masculinities. In examining constructions of masculinity and health within a relational context, this theory proposes that health behaviours are used in daily interactions in the social structuring of gender and power. It further proposes that the social practices that undermine men's health are often signifiers of masculinity and instruments that men use in the negotiation of social power and status. This paper explores how factors such as ethnicity, economic status, educational level, sexual orientation and social context influence the kind of masculinity that men construct and contribute to differential health risks among men in the United States. It also examines how masculinity and health are constructed in relation to femininities and to institutional structures, such as the health care system. Finally, it explores how social and institutional structures help to sustain and reproduce men's health risks and the social construction of men as the stronger sex.
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            Recovering the feminine other: masculinity, femininity, and gender hegemony

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              Masculinities

              A landmark study of men and masculinity from one of Australia's leading social scientists. Traces the development of modern Western masculinities over 400 years, showing how gender was closely connected with empire and the creation of a global economy.
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                Author and article information

                Contributors
                +46 18 471 62 28 , anna.hoglund@crb.uu.se
                marianne.carlsson@pubcare.uu.se
                inger.holmstrom@mdh.se
                elenor.kaminsky@mdh.se
                Journal
                Int J Equity Health
                Int J Equity Health
                International Journal for Equity in Health
                BioMed Central (London )
                1475-9276
                21 September 2016
                21 September 2016
                2016
                : 15
                : 152
                Affiliations
                [1 ]Department of Public Health and Caring Sciences, Box 564, SE-751 22 Uppsala, Sweden
                [2 ]University of Gävle, 801 76 Gävle, Sweden
                [3 ]School of health, care and social welfare, Mälardalen University, Box 883, 721 23 Västerås, Sweden
                Article
                447
                10.1186/s12939-016-0447-0
                5031285
                27654327
                83102d13-85de-417c-afc1-ab8bb7ddaf33
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 29 March 2016
                : 15 September 2016
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100004359, Vetenskapsrådet;
                Categories
                Research
                Custom metadata
                © The Author(s) 2016

                Health & Social care
                equity in health,intersectional perspective,intervention study,telephone nursing,sweden

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