Introduction Understanding of attitudes, knowledge, and behaviour related to evidence-based practice (EBP) and guidelines in Swedish occupational therapy is limited. The study aims were to investigate attitudes, knowledge, and behaviour related to evidence-based practice and guidelines of Swedish occupational therapists in primary care. Methods A web-based survey of 94 Swedish primary care occupational therapists (response rate 53.7%). Data were analysed using logistic regressions. Results Attitudes towards EBP and guidelines were highly positive (97%–98%). About half of the respondents reported confidence in finding and using evidence. Almost two-thirds reported being aware of guidelines and 47% knowing where to find guidelines. Four-fifths stated that they had easy access to guidelines and 75% that they used guidelines frequently. Men were more likely to feel confident to find research (OR 8.58, 95% CI 1.03 to 71.66; p = 0.047) and have easy access to guidelines (OR 9.10, 95% CI 1.94 to 42.83; p = 0.005). Occupational therapists older than 50 years were more likely to integrate patient preferences with guideline use (OR 6.44, 95% CI 1.14 to 36.57; p = 0.035). Few reported reading scientific articles, and many expressed uncertainty in finding research. The main barrier for using guidelines was reported to be lack of time. Conclusion Although attitudes among primary care occupational therapists towards EBP are positive and a large proportion report using guidelines, many state that they want to learn more and improve their evidence-based practice skills. The findings suggest that education measures need to be taken to address the identified shortcomings.

Sepsis is the main cause of death in the intensive care units (ICU) and increasing incidences of ICU admissions for sepsis are reported. Identification of patients at risk for sepsis and poor outcome is therefore of outmost importance. We performed a nation-wide case–control study aiming at identifying and quantifying the association between co-morbidity and socio-economic factors with intensive care admission for community-acquired sepsis. We also explored 30-day mortality. All adult patients (n = 10,072) with sepsis admitted from an emergency department to an intensive care unit in Sweden between 2008 and 2017 and a control population (n = 50,322), matched on age, sex and county were included. In the sepsis group, 69% had a co-morbid condition at ICU admission, compared to 31% in the control group. Multivariable conditional logistic regression analysis was performed and there was a large variation in the influence of different risk factors associated with ICU-admission, renal disease, liver disease, metastatic malignancy, substance abuse, and congestive heart failure showed the strongest associations. Low income and low education level were more common in sepsis patients compared to controls. The adjusted OR for 30-day mortality for sepsis patients was 132 (95% CI 110–159) compared to controls.

BackgroundSeveral reports indicate gender disparities in health care provision. There is a well-documented male patient dominance in intensive care unit (ICU) admittance. It is not established if this difference reflects medical needs or is influenced by other factors. The aim of the current study was to investigate if patient gender influences the pattern of ICU admittance in a cohort of trauma patients.MethodsData from patients admitted to an urban trauma centre over a 10-year interval were linked to regional and national health registries to obtain data on demographics, co-comorbidities, trauma-related variables, ICU-admittance patterns and mortality. The association between gender and ICU-admission were explored using logistic regression analysis. The association between gender and short- and long-term mortality were explored using Cox regression models.ResultsIn this study cohort of approximately 14,000 trauma patients, men had a higher probability of being admitted to the ICU after initial trauma resuscitation. The difference was limited to patients with less severe injuries (ISS < 15). No differences were noted in short-term survival, whereas men had a higher long-term mortality.ConclusionsIn this retrospective cohort study we found a difference between men and women in post trauma ICU admittance patterns, restricted to less injured patients, where men had a higher probability of ICU admittance. Whether this is a true gender bias or an effect of other factors not analysed in this study remains unknown. This finding warrants further studies.