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Bockgård, G., Mattsson, E., von Essen, L. & Klarare, A. (2024). Collaborative Interpretation of Researcher-Generated Photo-Elicitation Findings: Insights From Women With Lived Experience of Homelessness. Qualitative Health Research
Open this publication in new window or tab >>Collaborative Interpretation of Researcher-Generated Photo-Elicitation Findings: Insights From Women With Lived Experience of Homelessness
2024 (English)In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557Article in journal (Refereed) Epub ahead of print
Abstract [en]

Interviews with individuals experiencing homelessness can be challenging for various reasons, including mental and physical health issues, substance use, and negative experiences with authority figures. Researchers have used photos to facilitate communication and empower participants during data collection. We analyzed data from a previous study to explore the use of researcher-generated photos during interviews about health with 13 women experiencing homelessness. Conversation analysis revealed clear patterns regarding the use of the photos during the interviews. The photos were referred to 118 times over the total interview length, 6 hours and 23 minutes, with the interviewer making 62% of the referrals and the women accounting for 38%. Fifty-nine percent of the referrals occurred within the first 5 minutes of the interviews. The women used the photos to trigger associations and emotions, to describe photo content, or in a minor role during the interview. Interpretations from an advisory board of six women with lived experiences of homelessness suggested that the photos did not engage participants as intended, highlighting the importance of considering participants’ perspectives when designing photo-elicitation methods. The feedback also provided valuable insights into interview locations and incentives in research that may have influenced the women’s willingness to use the photos. This study emphasizes the importance of understanding the complexity of choosing researcher-generated photos in interviews with underserved, hard-to-reach populations.

Keywords
Homelessness, Photo-elicitation, Researcher-generated photos, Women, Qualitative
National Category
Health Sciences
Identifiers
urn:nbn:se:esh:diva-10629 (URN)10.1177/10497323231224330 (DOI)38235734 (PubMedID)
Available from: 2024-01-18 Created: 2024-01-18 Last updated: 2024-01-19Bibliographically approved
Klarare, A., Ekström, V., Godskesen, T., Westman, J., Mattsson, E. & Kneck, Å. (2024). Treatment of trauma-related conditions for people in homelessness: A scoping review. Journal of social distress and the homeless
Open this publication in new window or tab >>Treatment of trauma-related conditions for people in homelessness: A scoping review
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2024 (English)In: Journal of social distress and the homeless, ISSN 1053-0789, E-ISSN 1573-658XArticle, review/survey (Refereed) Epub ahead of print
Abstract [en]

People in homelessness face significant health inequities, with tri-morbidity, exposure to violence, substance use- and post-traumatic stress disorder. The aim of this scoping review was to describe treatments for trauma-related conditions for persons in homelessness. Systematic searches were performed in three databases: PubMed, PsycInfo and Scopus, guided by the PRISMA checklist. Nine studies fulfilled the criteria and were included in the review. Results show no randomized studies specifically focusing on treatment of trauma-related conditions for people in homelessness. Studies described interventions or programs that focused on consolidating and developing participants’ own strengths and skills to better navigate life with the challenges of homelessness, trauma, and PTSD. Treatment of trauma-related conditions may have positive effects for people in homelessness, as for others. Multimodal treatments, developing personal strengths and skills for people in homelessness, show potential to decrease trauma symptoms, however, more robust studies are needed for inferences and recommendations. 

Place, publisher, year, edition, pages
Taylor & Francis, 2024
Keywords
Homelessness, Scoping review, Therapies, Trauma, Treatment
National Category
Health Sciences
Identifiers
urn:nbn:se:esh:diva-10708 (URN)10.1080/10530789.2024.2310948 (DOI)
Funder
Swedish Research Council, 2019-01095Forte, Swedish Research Council for Health, Working Life and Welfare, 2020-169
Available from: 2024-02-13 Created: 2024-02-13 Last updated: 2024-02-13Bibliographically approved
Gaber, S., Klarare, A., Mattsson, E. & Karlsson Rosenblad, A. (2023). A comparison of perceptions of caring behaviours among women in homelessness, Registered Nurses and nursing students. Scandinavian Journal of Caring Sciences, 37(4), 959-969
Open this publication in new window or tab >>A comparison of perceptions of caring behaviours among women in homelessness, Registered Nurses and nursing students
2023 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 37, no 4, p. 959-969Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The population of women in homelessness in Europe is increasing and women in homelessness experience multiple healthcare needs. However, there is insufficient understanding about how perceptions of caring behaviours compare between women in homelessness as patients and nurses in their clinical practice.

AIM: This study aimed to investigate perceptions of caring behaviours among women in homelessness, Registered Nurses and nursing students.

METHODS: A cross-sectional design was used with convenience sampling to recruit groups of women in homelessness (n = 37), Registered Nurses (n = 92) and nursing students (n = 142) in Stockholm, Sweden. Between August 2019 and December 2020, data were collected through face-to-face interviews or online, using the Caring Behaviours Inventory-24 instrument. Data were analysed using descriptive statistics and group-comparing hypothesis tests.

RESULTS: Overall, women in homelessness' perceptions of caring behaviours were significantly lower than nursing students (p < 0.001), who in turn scored significantly lower than Registered Nurses (p < 0.001). The Knowledge and Skill domain had the highest score, and the Connectedness domain had the lowest score in all three groups. The ranking of the individual items according to score varied between the groups. However, all three groups had the highest score for the Knowing how to give shots, IVs, etc., item and the lowest score for the Helping the patient to grow item.

CONCLUSION: Healthcare providers and nurse educators should consider incongruences and congruences in caring behaviours to better prepare Registered Nurses and nursing students to contribute to increased health equity, and more targeted clinical practice for women in homelessness.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2023
Keywords
Caring behaviours, Homelessness, Nurse-patient relations, Nursing students, Registered nurses, Women
National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-9426 (URN)10.1111/scs.13071 (DOI)000758136400001 ()35187681 (PubMedID)
Funder
Swedish Research Council, 2019-01095Forte, Swedish Research Council for Health, Working Life and Welfare, 2020-00169
Available from: 2022-02-28 Created: 2022-02-28 Last updated: 2023-12-13Bibliographically approved
Steindal, S. A., Nes, A. A., Godskesen, T., Holmen, H., Winger, A., Österlind, J., . . . Klarare, A. (2023). Advantages and Challenges of Using Telehealth for Home-Based Palliative Care: A Systematic Mixed Studies Review. Journal of Medical Internet Research, 25
Open this publication in new window or tab >>Advantages and Challenges of Using Telehealth for Home-Based Palliative Care: A Systematic Mixed Studies Review
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2023 (English)In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 25Article, review/survey (Refereed) Published
Abstract [en]

Background: Owing to the increasing number of people with palliative care needs and the current shortage of health care professionals (HCPs), providing quality palliative care has become challenging. Telehealth could enable patients to spend as much time as possible at home. However, no previous systematic mixed studies reviews have synthesized evidence on patients’ experiences of the advantages and challenges of telehealth in home-based palliative care.

Objective: In this systematic mixed studies review, we aimed to critically appraise and synthesize the findings from studies that investigated patients’ use of telehealth in home-based palliative care, focusing on the advantages and challenges experienced by patients.

Methods: This is a systematic mixed studies review with a convergent design. The review is reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. A systematic search was performed in the following databases: Allied and Complementary Medicine Database, CINAHL, Cochrane Central Register of Controlled Trials, Embase, Latin American and Caribbean Health Sciences Literature, MEDLINE, PsycInfo, and Web of Science. The inclusion criteria were as follows: studies using quantitative, qualitative, or mixed methods; studies that investigated the experience of using telehealth with follow-up from HCPs of home-based patients aged ≥18; studies published between January 2010 and June 2022; and studies published in Norwegian, Danish, Swedish, English, Portuguese, or Spanish in peer-reviewed journals. Five pairs of authors independently assessed eligibility of the studies, appraised methodological quality, and extracted data. The data were synthesized using thematic synthesis.

Results: This systematic mixed studies review included 41 reports from 40 studies. The following 4 analytical themes were synthesized: potential for a support system and self-governance at home; visibility supports interpersonal relationships and a joint understanding of care needs; optimized information flow facilitates tailoring of remote caring practices; and technology, relationships, and complexity as perpetual obstacles in telehealth.

Conclusions: The advantages of telehealth were that patients experience a potential support system that could enable them to remain at home, and the visual features of telehealth enable them to build interpersonal relationships with HCPs over time. Self-reporting provides HCPs with information about symptoms and circumstances that facilitates tailoring care to specific patients. Challenges with the use of telehealth were related to barriers to technology use and inflexible reporting of complex and fluctuating symptoms and circumstances using electronic questionnaires. Few studies have included the self-reporting of existential or spiritual concerns, emotions, and well-being. Some patients perceived telehealth as intrusive and a threat to their privacy at home. To optimize the advantages and minimize the challenges with the use of telehealth in home-based palliative care, future research should include users in the design and development process.

Place, publisher, year, edition, pages
JMIR Publications, 2023
Keywords
Digital health, eHealth, Health care technology, Home-based palliative care, Review, Systematic mixed studies review, Telemedicine, Mobile phone
National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-10126 (URN)10.2196/43684 (DOI)000936731300001 ()36912876 (PubMedID)
Available from: 2023-03-13 Created: 2023-03-13 Last updated: 2024-02-09Bibliographically approved
Mattsson, E. & Klarare, A. (2023). Kvinnor far illa inom ramen för samhällets institutioner. Dagens arena (2023-04-14)
Open this publication in new window or tab >>Kvinnor far illa inom ramen för samhällets institutioner
2023 (Swedish)In: Dagens arena, no 2023-04-14, p. 1Article in journal, News item (Other (popular science, discussion, etc.)) Published
Abstract [sv]

Vårdprogram, journalsystem och arbetsrutiner bör ändras för att öka säkerheten för kvinnor med skyddade personuppgifter. 

Place, publisher, year, edition, pages
Stockholm: , 2023. p. 1
National Category
Health Sciences
Identifiers
urn:nbn:se:esh:diva-10172 (URN)
Available from: 2023-04-24 Created: 2023-04-24 Last updated: 2023-04-28Bibliographically approved
Wergeland, D., Harsten, K., Klarare, A. & Steindal, S. A. (2023). Title authors reply to letter to Editor 'Follow-up care after stem-cell transplant' [Letter to the editor]. Journal of Clinical Nursing, 32(13-14), 4195-4196
Open this publication in new window or tab >>Title authors reply to letter to Editor 'Follow-up care after stem-cell transplant'
2023 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 32, no 13-14, p. 4195-4196Article in journal, Letter (Other academic) Published
Place, publisher, year, edition, pages
Wiley-Blackwell, 2023
National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-9694 (URN)10.1111/jocn.16436 (DOI)000822936600001 ()35818338 (PubMedID)
Available from: 2022-08-03 Created: 2022-08-03 Last updated: 2024-02-09Bibliographically approved
Agius, J., Klarare, A., Mattsson, E., Vamstad, J., Eriksson Lundström, J. & Vahlman, S. (2023). Vilket stöd våldsutsatta får blir ett lotteri: Ge kommuner ett särskilt bostadsförsörjningskrav för våldsutsatta. Dagens Samhälle, Article ID 2023-06-08.
Open this publication in new window or tab >>Vilket stöd våldsutsatta får blir ett lotteri: Ge kommuner ett särskilt bostadsförsörjningskrav för våldsutsatta
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2023 (Swedish)In: Dagens Samhälle, article id 2023-06-08Article in journal, News item (Other (popular science, discussion, etc.)) Published
Abstract [sv]

Inrätta en nationell handlingsplan som säkerställer skydd, stöd och stadigvarande boende för våldsutsatta oavsett kommun, föreslår forskare i ett projekt om kvinnor i hemlöshet.

National Category
Health Sciences
Identifiers
urn:nbn:se:esh:diva-10310 (URN)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2023-06-17 Created: 2023-06-17 Last updated: 2023-06-19Bibliographically approved
Mattsson, E., Lindblad, M., Kneck, Å., Salzmann-Eriksson, M. & Klarare, A. (2023). Voices of women in homelessness during the outbreak of the COVID-19 pandemic: A co-created qualitative study. BMC Women's Health, 23(11)
Open this publication in new window or tab >>Voices of women in homelessness during the outbreak of the COVID-19 pandemic: A co-created qualitative study
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2023 (English)In: BMC Women's Health, E-ISSN 1472-6874, Vol. 23, no 11Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Women in homelessness face extreme health- and social inequities. It could be postulated that during societal crises, they become even more vulnerable. Thus, the aim was to explore experiences related to the COVID-19 pandemic among women in homelessness.

METHODS: Ten interviews were conducted with women in homelessness, in Stockholm, Sweden, using researcher-driven photo elicitation. The data analysis was guided by the DEPICT model for collaborative data analysis and a qualitative content analysis was performed. A collaborative reference group of women with lived experience of homelessness contributed to the research process through designing the data collection, performing the data analysis, and providing feedback during report writing.

RESULTS: For women in homelessness, the COVID-19 pandemic was adding insult to injury, as it significantly affected everyday life and permeated most aspects of existence, leading to diminished interactions with others and reduced societal support. Thus, in an already dire situation, the virus amplified health- and social issues to another level. The women strived to find their balance on the shifting sands of guidelines and restrictions due to the pandemic. Adhering to the new social distancing rules and guidelines in line with the rest of society, was simply impossible when experiencing homelessness. However, for some women the pandemic was nothing but a storm in a teacup. The harsh reality continued irrespectively, living one day at a time and prioritizing provision for basic human needs.

CONCLUSIONS: The COVID-19 pandemic and homelessness can be viewed as two intersecting crises. However, the women's aggregated experiences were greater than the sum of experiencing homelessness and meeting the threat of the virus. Gender, exposure to violence, poverty, social isolation, and substance use were additional factors that further marginalized the women during the pandemic. To rebuild a better and more sustainable post-pandemic future for all, global commitment to ending homelessness is crucial. In addition, addressing social determinants of health must be the number one health intervention.

Place, publisher, year, edition, pages
Springer, 2023
Keywords
COVID-19 pandemic, Homelessness, Inclusion health, Public involvement, Qualitative, Women
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:esh:diva-10001 (URN)10.1186/s12905-023-02157-x (DOI)000912027800003 ()36627642 (PubMedID)
Note

In collaboration with: Women Advisory Board for Inclusion Health. Ersta Möjlighet, Stockholm, Sweden.

Available from: 2023-01-11 Created: 2023-01-11 Last updated: 2024-02-09Bibliographically approved
Klarare, A., Carlsson, T. & Mattsson, E. (2022). Belonging to a community of care: Mothers' experiences of online peer support groups for parents having lost a child with congenital heart defects. Death Studies, 46(7), 1741-1749
Open this publication in new window or tab >>Belonging to a community of care: Mothers' experiences of online peer support groups for parents having lost a child with congenital heart defects
2022 (English)In: Death Studies, ISSN 0748-1187, E-ISSN 1091-7683, Vol. 46, no 7, p. 1741-1749Article in journal (Refereed) Published
Abstract [en]

The aim was to study mothers' experiences of online peer support groups after the death of a child. Participants (N = 8) were recruited through a newsletter for the Swedish association for families/children with heart defects, and two closed support groups on Facebook (900 and 100 members) and interviewed by telephone. Transcripts were analyzed with qualitative content analysis. The groups were available around the clock, regardless of support need, and mothers joined both to receive and provide support. Participation in online peer support groups may provide a sense of belonging to a caring community and serve as a valuable complement to healthcare.

National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-8511 (URN)10.1080/07481187.2020.1850548 (DOI)000596970100001 ()33252318 (PubMedID)
Available from: 2020-12-01 Created: 2020-12-01 Last updated: 2022-08-03Bibliographically approved
Wallin, V., Mattsson, E., Omerov, P. & Klarare, A. (2022). Caring for patients with eating deficiencies in palliative care—Registered nurses' experiences: A qualitative study. Journal of Clinical Nursing, 31(21-22), 3165-3177
Open this publication in new window or tab >>Caring for patients with eating deficiencies in palliative care—Registered nurses' experiences: A qualitative study
2022 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 31, no 21-22, p. 3165-3177Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES: The aim was to explore RNs' experiences of caring for patients with eating deficiencies in palliative care.

BACKGROUND: Food and mealtimes are fundamental aspects for wellbeing and social interactions. The worldwide trajectory of ageing populations may result in increased need for palliative care. Everyday life with chronic life limiting illness and eating deficiencies is challenging for patients and families. RNs are key care providers at end-of-life.

DESIGN: A qualitative study with an inductive approach was used.

METHODS: Nineteen experienced RNs in palliative care were interviewed through telephone; interviews were audio recorded and transcribed verbatim. Inductive qualitative content analysis was performed, and the COREQ checklist was used to guide proceedings.

RESULTS: The overarching theme, Supporting persons with eating deficiencies in-between palliative care and end-of-life care, is represented by three sub-themes: Easy to stick with doing, Just being, without doing, is hard and Letting go. Near end-of-life, eating symbolized social belonging and quality of life for RNs, whereas for patients and families, eating symbolized life. RNs tried practical solutions, however, not always according to patients' and families' preferences.

CONCLUSIONS: RNs were well prepared to tackle physical inconveniences and provide support, however, less prepared to encounter existential, psychological and social issues in relation to eating deficiencies. Although RNs stated that human beings stop eating when they are about to die, letting nature run its' course and facilitating patients' transition to end-of-life care was challenging.

RELEVANCE TO CLINICAL PRACTICE: Food and mealtimes represent fundamental aspects of human life and denote central parts in RNs clinical practice in palliative care. The findings can inspire development of a comprehensive palliative care approach to support patients and families. Structured reflection in relation to clinical practice may support and encourage RNs, caring for patients with eating deficiencies, in mastering both doing and being.

Keywords
Caring, Eating problems, End-of-life, Families, Mealtime, Nursing, Nutrition, Palliative care, Patients
National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-9295 (URN)10.1111/jocn.16149 (DOI)000723896300001 ()34850477 (PubMedID)
Available from: 2021-12-07 Created: 2021-12-07 Last updated: 2023-02-16Bibliographically approved
Projects
Inclusion health for women in homelessness - development, feasibility and implementation of interventions [2020-00169_Forte]; Marie Cederschiöld University; Publications
Bockgård, G., Mattsson, E., von Essen, L. & Klarare, A. (2024). Collaborative Interpretation of Researcher-Generated Photo-Elicitation Findings: Insights From Women With Lived Experience of Homelessness. Qualitative Health ResearchKlarare, A., Ekström, V., Godskesen, T., Westman, J., Mattsson, E. & Kneck, Å. (2024). Treatment of trauma-related conditions for people in homelessness: A scoping review. Journal of social distress and the homelessAnonymous, . (2024). When the wounds heal but the soul bleeds: A lived experience narrative. Journal of Psychiatric and Mental Health NursingGaber, S., Klarare, A., Mattsson, E. & Karlsson Rosenblad, A. (2023). A comparison of perceptions of caring behaviours among women in homelessness, Registered Nurses and nursing students. Scandinavian Journal of Caring Sciences, 37(4), 959-969Kneck, Å. (2023). Fungerande, behovsstyrd och resursstärkande samverkan: Avgörande för att den våldsutsatta kvinnan i hemlöshet ska kunna erbjudas traumavård. In: : . Paper presented at NaPSa, Nationell paper-konferens i socialt arbete, Södertörns högskola, Stockholm, 22-23 mars 2023.. Mattsson, E. & Klarare, A. (2023). Kvinnor far illa inom ramen för samhällets institutioner. Dagens arena (2023-04-14)Stobin, R., Björling, A. & Kneck, Å. (2023). Orimliga krav på den som är sjuk och hemlös att ensam försöka navigera i ett svårtolkat strukturellt system: Erfarenheter hos personer i hemlöshet kring samverkan av vård- och omsorgsinsatser. Vårdmagasinet Hälsa : medlemstidning för distriktssköterskor (1), 28-29Agius, J., Klarare, A., Mattsson, E., Vamstad, J., Eriksson Lundström, J. & Vahlman, S. (2023). Vilket stöd våldsutsatta får blir ett lotteri: Ge kommuner ett särskilt bostadsförsörjningskrav för våldsutsatta. Dagens Samhälle, Article ID 2023-06-08. Mattsson, E., Lindblad, M., Kneck, Å., Salzmann-Eriksson, M. & Klarare, A. (2023). Voices of women in homelessness during the outbreak of the COVID-19 pandemic: A co-created qualitative study. BMC Women's Health, 23(11)Kneck, Å., Klarare, A., Mattsson, E. & Salzmann‐Erikson, M. (2022). Reflections on health among women in homelessness: A qualitative study. Journal of Psychiatric and Mental Health Nursing, 29(5), 709-720
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7935-3260

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