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  • 1.
    Ancillotti, Mirko
    et al.
    Uppsala universitet.
    Eriksson, Stefan
    Uppsala universitet.
    Veldwijk, Jorien
    The Netherlands.
    Nihlén Fahlquist, Jessica
    Uppsala universitet.
    Andersson, Dan I
    Uppsala universitet.
    Godskesen, Tove
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Uppsala universitet.
    Public awareness and individual responsibility needed for judicious use of antibiotics: a qualitative study of public beliefs and perceptions.2018In: BMC Public Health, E-ISSN 1471-2458, Vol. 18, no 1, article id 1153Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: High consumption of antibiotics has been identified as an important driver for the increasing antibiotic resistance, considered to be one of the greatest threats to public health globally. Simply informing the public about this consequence is insufficient to induce behavioral change. This study explored beliefs and perceptions among Swedes, with the aim of identifying factors promoting and hindering a judicious approach to antibiotics use. The study focused primarily on the medical use of antibiotics, also considering other aspects connected with antibiotic resistance, such as travelling and food consumption.

    METHODS: Data were collected through focus group discussions at the end of 2016. Twenty-three Swedes were recruited using an area-based approach and purposive sampling, aiming for as heterogeneous groups as possible regarding gender (13 women, 10 men), age (range 20-81, mean 38), and education level. Interview transcripts were analyzed using qualitative content analysis. The Health Belief Model was used as a theoretical framework.

    RESULTS: Antibiotic resistance was identified by participants as a health threat with the potential for terrible consequences. The severity of the problem was perceived more strongly than the actual likelihood of being affected by it. Metaphors such as climate change were abundantly employed to describe antibiotic resistance as a slowly emerging problem. There was a tension between individual (egoistic) and collective (altruistic) reasons for engaging in judicious behavior. The individual effort needed and antibiotics overprescribing were considered major barriers to such behavior. In their discussions, participants stressed the need for empowerment, achieved through good health communication from authorities and family physicians.

    CONCLUSIONS: Knowledge about antibiotic consumption and resistance, as well as values such as altruism and trust in the health care system, has significant influence on both perceptions of individual responsibility and on behavior. This suggests that these factors should be emphasized in health education and health promotion. To instead frame antibiotic resistance as a slowly emerging disaster, risks diminish the public perception of being susceptible to it.

  • 2.
    Bengtsson, Dennis
    et al.
    Högskolan i Halmstad.
    Landberg, Åsa
    Ersta Sköndal Bräcke University College, Department of Social Sciences.
    Jernbro, Carolina
    Karlstads universitet.
    Increased risk of child maltreatment and mental health problems among adolescents with restrictions regarding choice of future partner: Results from a Swedish school-based survey2022In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 50, no 8, p. 1133-1139Article in journal (Refereed)
    Abstract [en]

    Background: Honour-related violence and oppression is a violation of human rights and a public health problem. Oppressioncan be manifested by not being allowed to choose future partners and can increase the risk of abuse and mental healthproblems.

    Aims: The aim of this study was to investigate associations between restrictions regarding choice of future partner(RCP), child maltreatment and mental health problems among adolescents in Sweden.

    Methods: The study was based oncross-sectional data, including a nationally representative sample of 4741 pupils from grade nine in primary school and secondyear in high school. Pearson’s chi-square tests and binary logistical regression analyses adjusting for socio-demographicfactors were conducted.

    Results: RCP was significantly associated to child maltreatment, including poly-victimisation, andmental health problems. In the adjusted analysis, an increased risk for all types of maltreatment, poly-victimisation (adjustedodds ratio (aOR) 10.2, confidence interval (CI) 5.6–18.4), self-harm (aOR 1.9, CI 1.1–3.2) and suicide attempt (aOR 2.4,CI 1.3–4.7) were shown in adolescents exposed to RCP compared to non-exposed.

    Conclusions: There is an increasedrisk of child maltreatment including poly-victimisation and mental health problems among adolescents exposedto RCP compared to non-exposed. The study emphasizes the matter as a public health problem requiringimmediate preventive measures to ensure the rights of children and adolescents.

  • 3.
    Berg, Charlotte
    et al.
    Sveriges lantbruksuniversitet.
    Juuso, Päivi
    Luleå Tekniska Universitet.
    Lerner, Henrik
    Marie Cederschiöld University, Department of Health Care Sciences.
    Lidfors, Lena
    Sveriges lantbruksuniversitet.
    One Health: Samspelet mellan human-, djur- och ekosystemhälsa2022In: Vård, omsorg och rehabilitering utomhus: Teori, praktik och nya perspektiv / [ed] Åsa Engström; Päivi Juuso; Madeleine Liljegren; Lotta Lundmark Alfredsson; Anna Bengtsson, Lund: Studentlitteratur AB, 2022, p. 97-112Chapter in book (Other academic)
    Abstract [sv]

    Sambandet mellan människors, djurs och ekosystems hälsa är viktigt för att målet "En gemensam hälsa" skall uppnås. I detta kapitel förklarar vi vad One Health är, vilka teorier som ligger bakom One Health, vilka centrala begrepp och perspektiv som är viktiga för området och forskning om kopplingen mellan människors och djurs hälsa, människors och miljöns hälsa, samt djurens och miljöns hälsa. Vi tar upp olika aspekter rörande lantbruksdjur, sällskapsdjur och vilda djur och hur det sätt vi föder upp och sköter dem på påverkar miljön, och i det långa loppet även människor. Vi beskriver hur djurs sjukdomar kan påverka människors hälsa och omvänt, samt One Health-perspektivets koppling till vård, omsorg och rehabilitering utomhus.

  • 4.
    Bladh, Marie
    et al.
    Linköpings universitet.
    Svedin, Carl Göran
    Marie Cederschiöld University, Department of Social Sciences.
    Agnafors, Sara
    Linköpings universitet.
    Predictors of educational failure at 16 and 19 years of age: SESBiC longitudinal study2023In: PLOS ONE, E-ISSN 1932-6203, Vol. 18, no 1, article id e0279531Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Educational attainment is highly associated with future health and independence. Throughout childhood, children are exposed to factors that may promote educational attainment and factors that may be associated with a reduced likelihood of being able to complete their education. The purpose of the current study was to investigate which factors, measured from birth up to finishing upper secondary school, were associated with a lower mean grade point average from lower and upper secondary school as well as eligibility to upper secondary school and college/university.

    METHODS: This is a longitudinal study on 1723 children born in 1995/1996 who have been followed until they were 20 years old. Information with respect to maternal sociodemographics, maternal stress factors during pregnancy and childhood, birth characteristics of the child, child behavior at 3 and 12 years of age, and mean grade point average from lower and upper secondary school, including eligibility to upper secondary school and college/university was collected.

    RESULTS: Children exhibiting high problems scores on the child behavior checklist at 12 years of age and children or having other living arrangements (e.g. foster parents or institutional care) were less likely to fulfill the requirements for upper secondary school (OR = 0.35, 95% CI = 0.17-0.71 and OR = 0.33 95% CI = 0.17-0.65, respectively). The likelihood of fulfilling the requirements to college/university was lower if the child had divorced parents at three years of age (OR = 0.30, 95% CI = 0.16-0.58) and exhibited externalizing problems at 12 years of age (OR = 0.45, 95% CI = 0.24-0.86) and if the mother had experienced high level of stress at (OR = 0.32, 95% CI = 0.14-0.77).

    CONCLUSION: Identifying mothers with high level of stressors as well as children with externalizing behaviour problems to provide guidance and support is very important as these two factors appear to be associated with future study performance in both lower and upper secondary school.

  • 5.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Hälsa ur ett psykosomatiskt perspektiv2011In: Perspektiv på kvinnors hälsa i arbetslivet / [ed] Hélène Sandmark, Lund: Studentlitteratur, 2011, p. 65-84Chapter in book (Other academic)
  • 6.
    Bullington, Jennifer
    et al.
    Linköpings universitet.
    Karlsson, G
    Hur uppfattar en blind person sin kropp?1998In: Social forskning, ISSN 0283-202X, Vol. 13, p. 8-10Article in journal (Refereed)
  • 7.
    Carlander (Goliath), Ida
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Me-ness och We-ness: Individuell och gruppidentitet hos döende personer och deras familjemedlemmar2013In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 90, no 1, p. 165-171Article in journal (Refereed)
    Abstract [sv]

    Följande artikel är baserad på en avhandling som beskriver människors upplevelser av sin vardag hemma när en i familjen är svårt sjuk och döende och  fokuserar på centrala begrepp som identitet, död och gemenskap. Intervjuer med patienter och deras familjemedlemmar, delvis genomförda över tid, har möjliggjort analyser av berättelser som speglar vardagliga processer, liksom transitioner och rollförändringar. För både patienter och familjemedlemmar medförde vardagen i hemmet en rad fysiska, psykiska och sociala påfrestningar. För familjemedlemmarna innebar det bland annat att dela livet med en förändrad person i en förändrad relation. Vardagen nära döden innebar att möta nya situationer och erfarenheter som utmanade den personliga identiteten; me-ness liksom familjeidentiteten; we-ness.

  • 8.
    Donevan, Meghan
    et al.
    Ersta Sköndal Bräcke University College, Department of Social Sciences.
    Jonsson, Linda
    Ersta Sköndal Bräcke University College, Department of Social Sciences.
    Bladh, Marie
    Linköpings universitet.
    Priebe, Gisela
    Lunds universitet.
    Fredlund, Cecilia
    Linköpings universitet.
    Svedin, Carl Göran
    Ersta Sköndal Bräcke University College, Department of Social Sciences.
    Adolescents' Use of Pornography: Trends over a Ten-year Period in Sweden2022In: Archives of Sexual Behavior, ISSN 0004-0002, E-ISSN 1573-2800, Vol. 51, no 2, p. 1125-1140Article in journal (Refereed)
    Abstract [en]

    Using survey data from three nationally representative surveys in 2004, 2009, and 2014 among senior high school students in Sweden, this study investigates trends in adolescents' lifetime prevalence of pornography use, frequency of pornography use, and type of pornography used over time. While almost all boys and a considerable proportion of girls used pornography across the three waves, the lifetime prevalence of pornography use decreased overall for both girls and boys. The share of boys who use pornography frequently increased over the three survey cycles; those who reported using pornography daily increased from 11% in 2004 to 24% in 2014. In contrast, there was no change in girls who reported using pornography daily, while the proportion who never used pornography increased from 40% in 2004 to 51% in 2014. Adolescents appear to use a narrower range of different pornography types over the survey cycles. Multiple logistic regression models were generated to investigate factors associated with pornography use over the 10-year period. The results suggest that rule-breaking behavior, having higher economic status and higher academic achievement were related to boy's pornography use, while rule-breaking behavior, early sexual debut and victimization were associated with girls' pornography use.

  • 9.
    Eriksson, Ulrika
    et al.
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet.
    Sellström, Eva
    Mittuniversitetet.
    Growing up in rural community: children's experiences of social capital from perspectives of wellbeing2010In: Rural and remote health, ISSN 1445-6354, Vol. 10, no 3, article id 1322Article in journal (Refereed)
    Abstract [en]

    Introduction: People are influenced by the neighborhood in which they live. The neighborhood may be particularly important for children’s wellbeing because of the constraints it imposes on their patterns of daily activities. Furthermore, the neighborhood is a central context for social development, being a place where children form networks and learn social skills and values. The aim of this study was to describe how social capital in the neighborhood is perceived by children living in rural areas, and to reveal what this adds to their sense of wellbeing.

    Methods: The study had a descriptive research design with a qualitative approach. Seven single-sex focus group interviews were conducted with children the in 6th grade (aged 11–12 years). Data were analyzed using deductive content analysis.

    Results: The children perceived a lack of social capital due to environmental and social constraints in their everyday lives. However, their wellbeing was enhanced by strong cohesion in the neighborhood. In addition, settings such as the school, the natural environment, and sporting associations were highly valued and emerged as crucial factors for enhancing the children’s wellbeing. The spatial isolation that characterizes rural areas created a special context of social network structures, cohesion and trust, but was also a breeding ground for exclusion and social control. The stories revealed paradoxical feelings of living in a good and safe area that simultaneously felt isolated and restricted.

    Conclusions: From a rural perspective, this study reveals the complexity of the children’s perceptions of their social environment, and the ways in which these perceptions have both positive and negative effects on wellbeing. The results highlight how important it is for health professionals in rural areas to consider the complex influence of bonding social capital on children’s wellbeing, and to be aware that it can promote exclusion as well as cohesion.

  • 10.
    Esmat Hosseini, Seyedeh
    et al.
    Shahid Beheshti University of Medical Sciences, Tehran, Iran.
    Ilkhani, Mahnaz
    Shahid Beheshti University of Medical Sciences, Tehran, Iran.
    Rohani, Camelia
    Marie Cederschiöld University, Department of Health Care Sciences, Palliative Research Centre, PRC. Shahid Beheshti University of Medical Sciences, Tehran, Iran.
    Nikbakht Nasrabadi, Alireza
    Tehran University of Medical Sciences, Tehran, Iran.
    Ghanei Gheshlagh, Raza
    Kurdistan University of Medical Sciences, Sanandaj, Iran.
    Moini, Ashraf
    Tehran University of Medical Sciences, Tehran, Iran; Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Tehran University of Medical Sciences, Tehran, Iran.
    Prevalence of sexual dysfunction in women with cancer: A systematic review and meta-analysis2022In: International journal of reproductive biomedicine, ISSN 2476-4108, Vol. 20, no 1, p. 1-12Article, review/survey (Refereed)
    Abstract [en]

    Background: Cancer is one of the most common diseases and it has many physical and psychological consequences. Women with cancer are more likely to suffer from sexual dysfunction (SD) than healthy women.

    Objective: To estimate the overall prevalence of SD in women with cancer.

    Materials and Methods: The international databases Google Scholar, Embase, PubMed, Web of Science, and Scopus were searched for related articles without any time limitation. The keywords "Neoplasia", "Tumor", "Cancer", "Malignancy", "Female Sexual Function Index", "FSFI", and "female sexual dysfunction" along with their combinations were used in the search. Inconsistencies in the data were examined using the I2 test. The data were analyzed using the meta-analysis method and the random-effects model in the Stata software.

    Results: The analysis of 24 articles with a sample size of 5483 women showed that the prevalence of SD in women with cancer was 66% (95% CI: 59-74%). The highest and lowest prevalence were in Africa and Europe, respectively (75%; 95% CI: 66-83% vs. 43%; 95% CI: 26-60%, respectively). There was no relationship between the prevalence of SD and the mean age of the women, sample size, yr of publication, or quality of articles.

    Conclusion: SD is highly prevalent in women with cancer. African and American women with cancer have a higher average SD prevalence than Asian and European ones.

  • 11.
    Gärde, Johan
    Ersta Sköndal Bräcke University College, Department of Social Sciences.
    Intervention logics in global and international poverty reduction schemes for the extreme poor and the most deprived with a focus on wellbeing and health2017In: O Mundo da Saúde, ISSN 0104-7809, E-ISSN 1980-3990, Vol. 40, no A, p. 483-506Article in journal (Refereed)
    Abstract [en]

    This article will treat the intervention logics of three major global and international poverty reduction programs with a focus on wellbeing and health. The analytical framework of the Millennium Development Goals, the Sustainable Development Goals and the EU Fund for European Aid to the Most Deprived were compared using content and discourse analysis with an interpretative and critical approach. A major shift is taking place globally in the view of poverty reduction, with enhanced intervention logics which are complex as the targets and indicators are formulated by different stakeholders in both developed and developing contexts during diverse time-spans and a variety of priorities, which might not converge in core-dimensions, such as wellbeing, health and social protection. A more interdisciplinary and holistic view is now part of frameworks such as the Sustainable Development Goals, emphasizing environmental and eco-system dimensions in addition to traditional human development dimensions, like income, health, and education, where the impact also should be able to be measured, understood and valued in the interplay of environmental, economic and social determinants affecting wealth, welfare and ultimately, the health and wellbeing of persons and communities. International development funding is now not only restricted to development cooperation to the least developed countries, but middle development countries in Europe and other places, can now also access these aid funds. In addition, to reach out to the most deprived, welfare spending from developed nations are increasingly being allocated to international poverty reduction schemes through regional agendas, like the Europe Strategy 2020. The risk is that too many schemes and policies are not converging in the intervention logics. Another challenge is related to indicators and the resource allocation mainly emphasizing long-term and environmental concerns, such as eco-systems on the macro-level, which might affect short-and medium terms efforts to address human and humanitarian needs and essential health services for the extreme poor and the most deprived, wherever they are, as the geography of the poor is changing.

  • 12.
    Hoffmann, Ulrike
    et al.
    University Hospital Ulm, Germany.
    Svedin, Carl Göran
    Marie Cederschiöld University, Department of Social Sciences.
    Anagnostopoulus, D
    National and Kapodistrian University of Athens, Greece.
    Raynaud, J P
    Toulouse University Hospital, France.
    Räberg Christensen, A M
    Child and Adolescent Psychiatric Center, Denmark.
    Fegert, Jörg M
    University Hospital Ulm, Germany.
    Protection of patients against violence in medical institutions and the need for general safeguarding measures2022In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 31, no 9, p. 1337-1339Article in journal (Other academic)
  • 13.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet.
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC. Göteborgs universitet.
    Morin, Lucas
    Karolinska institutet.
    Cohen, Joachim
    Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium .
    A population-level study of place of death and associated factors in Sweden2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 7, p. 744-751Article in journal (Refereed)
    Abstract [en]

    Aims: The aims of this study were to examine, on a population level, where people die in Sweden, and to investigate associations between place of death and underlying cause of death, socioeconomic and environmental characteristics, with a particular interest in people dying from life-limiting conditions typically in need of palliative care. Methods: This population-level study is based on death certificate data for all deceased individuals in Sweden in 2012, with a registered place of death (n=83,712). Multivariable logistic regression was performed to investigate associations between place of death and individual, socioeconomic and environmental characteristics. Results: The results show that, in 2012, 42.1% of all deaths occurred in hospitals, 17.8% occurred at home and 38.1% in nursing home facilities. Individuals dying of conditions indicative of potential palliative care needs were less likely to die in hospital than those dying of other conditions (OR = 0.73; 95% CI = 0.70–0.77). Living at home in urban areas was associated with higher likelihood of dying in hospital or in a nursing home (OR = 1.04 and 1.09 respectively). Educational attainment and marital status were found to be somewhat associated with the place of death. Conclusions: The majority of deaths in Sweden occur in institutional settings, with comparatively larger proportions of nursing home deaths than most countries. Associations between place of death and other variables point to inequalities in availability and/or utilization of health services at the end of life.

  • 14.
    Johansson, Henrik
    Ersta Sköndal University College, Department of Health Care Sciences.
    Stressors in Ugandan nurses’ working- environment: An observational study2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Stress is a common problem for nurses around the world. In Uganda, the enormous pressure on the healthcare in the country makes it no different.

    Aim: To describe stressors in nurses’ working-environment in one hospital, one clinic and one refugee-camp in central and western Uganda.

    Methods: A qualitative observational study with observations from three different health facilities. The data was analyzed using content analysis by Graneheim and Lundman.

    Results: The results showed that factors like lack of equipment, improper handling of needles, exposure to contagion, environmental factors and information were all contributing to stress.

    Discussions: The result was discussed from two themes: Lack of safety and Knowledge related to lack of equipment. The first theme described the environmental hazards the nurses were exposed to in their proffession. The second described the relationship between knowledge, lack of equipment and stress.

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  • 15.
    Junehag, Lena
    et al.
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet.
    Svedlund, Marianne
    Mittuniversitetet.
    A qualitative study: Perceptions of the psychosocial consequences and access to support after an acute myocardial infarction2014In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 30, no 1, p. 22-30Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to describe individuals' perceptions of the psychosocial consequences of an acute myocardial infarction (AMI) and of their access to support one year after the event. Methods: The study included 20 participants (14 men and six women) who lived in rural areas and had experienced their first AMI. Eleven were offered contact with a mentor. The participants were interviewed one year after their AMI. Results: The findings are presented in three themes: having a different life, having to manage the situation and having access to support, with 11 subthemes. During their recovery, the participants experienced psychosocial consequences, consisting of anxiety and the fear of being afflicted again. Most mentees appreciated their mentor and some of those without mentors wished they had received organised support. Participants were often more dissatisfied than satisfied with the follow-up provided during recovery. Conclusions: After an AMI, follow-up is important during recovery, but the standardised information provided is inadequate. During recovery, people need help dealing with existential crises. After discharge, receiving peer support from lay people with similar experiences could be valuable. The knowledge gleaned from this study could be used in education at coronary care units and in health care outside the hospital setting. © 2013 Elsevier Ltd.

  • 16.
    Karlsson, Elsa
    et al.
    Ersta Sköndal Bräcke University College, Department of Social Sciences.
    Klarare, Anna
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC.
    Mattsson, Elisabet
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Låt våra hemlösa få bo på de tomma hotellen2021In: Aftonbladet, ISSN 1103-9000, no 2021-03-21Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    DEBATT. Covid-19 pandemin är en kris som påverkar samhällen i hela världen. Det är en utmanande tid för alla, men för socialt utsatta grupper, så som personer i hemlöshet, blir situationen ännu mer ohållbar.

  • 17.
    Karlsson, Magnus
    Ersta Sköndal Bräcke University College, Department of Social Sciences.
    Corona och fattigdom: Röster från de svenska stadsmissionerna2021In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 98, no 1, p. 71-81Article in journal (Refereed)
    Abstract [sv]

    Corona-pandemin får sociala konsekvenser även i välfärdssamhällen, inte minst för personer som redan befinner sig i mycket utsatta sociala situationer. Här presenteras hur de högsta cheferna (direktorerna) på Sveriges tio stadsmissioner resonerade kring att möta personer i fattigdom under pandemins första halvår.

  • 18.
    Karlsson, Magnus
    Ersta Sköndal Bräcke University College, Centre for Civil Society Research.
    Covid-19 och det civila samhället: En berättelse om människors initiativ2021In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 98, no 1, p. 9-14Article in journal (Other academic)
    Abstract [sv]

    I det här temanumret fokuseras de samhälleliga aspekterna av pandemin. Även om Covid-19 är en sjukdom som drabbar individer, så drabbas indirekt hela samhället och inte minst de grupper som redan är särskilt utsatta. Människors sociala livssituationer, ekonomier och relationer riskerar att skadas i kölvattnet av pandemin. Samtidigt finns gott om exempel på hur enskilda personer, grupper och organisationer uppvisar kreativitet, medmänsklighet och uthållighet när samhället prövas i sin helhet.

  • 19.
    Karlsson Rosenblad, Andreas
    et al.
    Department of Statistics, Uppsala University; Department of Statistics, Uppsala University, Akademiska sjukhuset; Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet.
    Klarare, Anna
    Marie Cederschiöld University, Department of Health Care Sciences, Palliative Research Centre, PRC. Department of Women’s and Children’s Health, Healthcare Services and e-Health, Uppsala University, Akademiska sjukhuset.
    Rapaport, Penny
    Division of Psychiatry, Faculty of Brain Sciences, University College London, UK.
    Mattsson, Elisabet
    Marie Cederschiöld University, Department of Health Care Sciences. Department of Women’s and Children’s Health, Healthcare Services and e-Health, Uppsala University, Akademiska sjukhuset.
    Gaber, Sophie Nadia
    Marie Cederschiöld University, Department of Health Care Sciences. Department of Women’s and Children’s Health, Healthcare Services and e-Health, Uppsala University, Akademiska sjukhuset.
    Health literacy and its association with mental and spiritual well-being among women experiencing homelessness2024In: Health Promotion International, ISSN 0957-4824, E-ISSN 1460-2245, Vol. 39, no 2Article in journal (Refereed)
    Abstract [en]

    Low health literacy (HL) has been linked to low self-rated health, reduced efficacy of behaviour change, and challenges in preventing, treating, or managing health conditions. People experiencing homelessness are at risk of poor HL; however, few studies have investigated HL in relation to mental and spiritual well-being among people experiencing homelessness in general, or women experiencing homelessness specifically. This cross-sectional study of 46 women experiencing homelessness in Stockholm, Sweden, recruited during the period October 2019–December 2020, aimed to examine how HL was associated with mental and spiritual well-being among women experiencing homelessness. Participants answered questions about socio-demographic characteristics (age, length of homelessness, education) and digital technology (mobile phone/the Internet) use, in addition to Swedish language versions of three questionnaires administered through structured, face-to-face interviews: the Communicative and Critical Health Literacy Scale, the General Health Questionnaire 12 and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being. Data were analysed using linear regression, which revealed statistically significant associations between HL and mental well-being (p = .009), and between HL and spiritual well-being (p = .022). However, neither socio-demographic characteristics nor digital technology use were significantly associated with HL. In conclusion, promoting HL may improve mental and spiritual well-being in this vulnerable population. An advisory board of women with lived experiences of homelessness (n = 5) supported the interpretation of the findings and emphasised the need to consider HL in relation to basic needs such as ‘housing first’. Moreover, health information and services should be accessible to people with different degrees of HL.

  • 20.
    Kassman, Anders
    et al.
    Ersta Sköndal Bräcke University College, Centre for Civil Society Research.
    Kneck, Åsa
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Health-promotive and exclusionary mechanisms in civil society: A critical review of the empirical support for Putnam’s view of social capital2021In: Cogent Social Sciences, E-ISSN 2331-1886, Vol. 7, no 1, article id 1953768Article, review/survey (Refereed)
    Abstract [en]

    A critical, integrative review in the SocINDEX database was conducted to screen empirically grounded research on civil society and health among youth. Our initial search string resulted in 477 hits, and our final selection was 58 articles. We found both promotive and excluding processes emanating from civil society. The engaged participants seem to empower themselves and live healthier lives, but simultaneously, they tend to exclude those with poorer health and status. Civil society does not seem to have the ability to resolve the existing stratifications, and there are risks of reinforcing the existing inequalities. Partly due to insufficient theoretical detail, there was also significant room for circular reasoning since the operationalisations of participation in civil society, social capital and health often overlapped. Of the three mechanisms proposed by Robert Putnam as links between networks and health, social control seems to have the best support in the reviewed empirical studies.

  • 21.
    Kitzmüller, Gabriele
    et al.
    Faculty of Health and Society, Narvik University College, Norway; Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.
    Häggström, Terttu
    Faculty of Health and Society, Narvik University College, Norway.
    Asplund, Kenneth
    Faculty of Health Sciences, University of Tromsø, Tromsø, Norway; Department of Health Science, University of Mid Sweden, Sundsvall.
    Living an unfamiliar body: the significance of the long-term influence of bodily changes on the perception of self after stroke2013In: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633, Vol. 16, no 1, p. 19-29Article in journal (Refereed)
    Abstract [en]

    The aim of this study is to illuminate the significance of the long-term influence of bodily changes on the perception of self after stroke by means of narrative interviews with 23 stroke survivors. A phenomenological-hermeneutic approach inspired by the philosophy of Merleau-Ponty and Ricoeur is the methodological framework. Zahavi's understanding of the embodied self and Leder's concept of dys-appearance along with earlier research on identity guide the comprehensive understanding of the theme. The meaning of bodily changes after stroke can be understood as living with an altered perception of self. Stroke survivors perceive their bodies as fragile, unfamiliar and unreliable and tend to objectify them. The weak and discomforting body that 'cannot' demands constant, comprehensive awareness to keep itself in play. These long-term and often permanent consequences of bodily weakness may turn stroke survivors' intentionality inwards, away from external activities and projects and relationships with others. Negative judgements from others are added to lost roles and positions and threaten the vulnerable self. Stroke survivors try to regain familiarity with their body by their life-long project of testing its boundaries. Mastering important tasks helps them strengthen their self-concept. Health care workers should be aware of the embodied self and engage in long-term dialogues with stroke survivors to strengthen positive perceptions of body and self. More research is needed to understand destructive post-stroke phenomena such as fatigue and pain and to find effective methods to help stroke survivors regain wholeness of body and self.

  • 22.
    Kneck, Åsa
    et al.
    Marie Cederschiöld University, Department of Health Care Sciences.
    Kassman, Anders
    Marie Cederschiöld University, Institutionen för civilsamhälle och religion, Centre for Civil Society Research.
    Uppfattningar om fysisk aktivitet, idrott, fritid och hälsa: Forskning med flickor som inte deltar i idrottsrörelsen2022In: Vårdmagasinet Hälsa : medlemstidning för distriktssköterskor, ISSN 2003-1165, no 4Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Fysisk aktivitet är viktigt för alla barns hälsa, men flickor är mindre fysiskt aktiva än pojkar och minst fysiskt aktiva är flickor med utländsk bakgrund. I Sverige är barns fysiska aktivitet starkt förknippad med deltagande i idrottsrörelsen, som inte passar alla.

  • 23.
    Kvamme, Brita Odland
    et al.
    Division of Addiction and Specialized Psychiatry, University Hospital of North Norway, Tromsø, Norway.
    Asplund, Kenneth
    Department of Nursing Science, Mid-Sweden University, Sundsvall, Sweden.
    Bjerke, Trond Nergaard
    Psychiatric Research Center of Northern Norway, University Hospital of North Norway, Tromsø, Norway.
    Drinking resumption: Problematic alcohol use relapse after rehabilitation. A phenomenological hermeneutical perspective2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 4, p. 716-723Article in journal (Refereed)
    Abstract [en]

    The majority of patients being treated for alcohol abuse disorders experience one or more relapses after treatment. The fact that people use this inebriant in a way leading to so much harm and suffering might seem a conundrum. Therapists, family and others might find the person's relapse to be dramatic and upsetting, and one might question whether the person has the sufficient will or motivation to change. However, few previous studies have explored relapse from the patient's perspective. The aim of this study was to illuminate the patient's lived experience of relapse and to develop a deeper understanding of this phenomenon. The study consisted of qualitative interviews using a phenomenological hermeneutical approach. Three main themes emerged from the analyses: 'craving', 'self-image' and 'time'. The findings were discussed in the context of phenomenological literature. Cravings could occur unpredictably; nevertheless, craving was a common experience for the patients and signified a risk of relapse. Bodily experiences of craving were frequently mentioned, and alcohol addiction could be understood as to be a disease or a learned habit. Self-image was, at times, adversely affected by relapse episodes. Therefore, feelings of shame, self-respect and recognition were significant concepts. This study found that the perception of time as past, present and future greatly influenced the participants' experiences of relapse and rehabilitation. Thus, relapse was an upsetting and dramatic experience that could cause great discomfort and sometimes life-threatening situations. However, relapse could also be viewed as a planned event. This study highlights important truth and reality about alcoholism and relapse grounded in people's lived experience.

  • 24.
    Landstedt, Evelina
    et al.
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet.
    Gillander Gådin, Katja
    Mittuniversitetet.
    Understanding adolescent mental health: the influence of social processes, doing gender and gendered power relations2009In: Sociology of Health and Illness, ISSN 0141-9889, E-ISSN 1467-9566, Vol. 31, no 7, p. 962-978Article in journal (Refereed)
    Abstract [en]

    Despite a well-documented gender pattern in adolescent mental health, research investigating possible explanatory factors from a gender-theoretical approach is scarce. This paper reports a grounded theory study based on 29 focus groups. The aim was to explore 16- to 19-year-old students' perceptions of what is significant for mental health, and to apply a gender analysis to the findings in order to advance understanding of the gender pattern in adolescent mental health. Significant factors were identified in three social processes categories, including both positive and negative aspects: (1) social interactions, (2) performance and (3) responsibility. Girls more often experienced negative aspects of these processes, placing them at greater risk for mental health problems. Boys' more positive mental health appeared to be associated with their low degree of responsibility-taking and beneficial positions relative to girls. Negotiating cultural norms of femininity and masculinity seemed to be more strenuous for girls, which could place them at a disadvantage with regard to mental health. Social factors and processes (particularly responsibility), gendered power relations and constructions of masculinities and femininities should be acknowledged as important for adolescent mental health.

  • 25.
    Lerner, Henrik
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    A Proposal for a Comprehensive Human–Animal Approach of Evaluation for Animal-Assisted Interventions2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 22, p. 1-4, article id 4305Article in journal (Refereed)
    Abstract [sv]

    Background: An important field of human–animal interactions is animal-assisted interventions (AAIs), which refers to research on human–animal interactions in order to promote or facilitate health or education in humans. Very few studies among the rich literature on AAIs seem to include aspects of animal welfare and/or animal ethics. Also, very few studies on AAIs have a comprehensive human–animal approach that studies animals, humans, and the relations between them at the same time. This paper tries to argue for and present a possible comprehensive human–animal approach to evaluate AAIs.

    Methods: A combination of the species and role approach proposed by Lerner, the capability approach proposed by Nussbaum, and a modified comprehensive human–animal approach to evaluate AAIs proposed by Lerner and Silfverberg was philosophically analyzed.

    Results: This paper shows that the combination is the modified role and species version of the capabilities approach, and by following it one could do a comprehensive human–animal approach of an evaluation of AAIs.

    Conclusion: Although the aim was reached for horses and animal-assisted therapy, further work needs to be done for all species suggested in the IAHAIO (International Association of Human–Animal Interaction Organizations) White Paper as well as for all branches of AAIs in order to establish this comprehensive human–animal approach

  • 26.
    Lidin, Matthias
    et al.
    Karolinska institutet.
    Ekblom-Bak, Elin
    Gymnastik- och idrottshögskolan.
    Rydell Karlsson, Monica
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Karolinska institutet.
    Hellénius, Mai-Lis
    Karolinska institutet.
    Long-term effects of a Swedish lifestyle intervention programme on lifestyle habits and quality of life in people with increased cardiovascular risk.2018In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, no 6, p. 613-622, article id 1403494817746536Article in journal (Refereed)
    Abstract [en]

    AIMS: The aim of this study was to evaluate the effects of a structured intervention programme on lifestyle habits and quality of life after six months and one year in participants with increased cardiovascular risk.

    METHODS: Participants aged ≥18 years with increased cardiovascular risk were referred from primary health care and hospitals. The programme was launched at an outpatient clinic in a department of cardiology at a university hospital. It consisted of individual visits to a nurse for a health check-up and lifestyle counselling at baseline, after six months and at one year. In addition, five group sessions - focusing on nicotine, alcohol, physical activity, eating habits, stress, sleep and behavioural change - were offered to the participants and their relatives or friends. Lifestyle habits and quality of life were assessed with questionnaires at baseline, after six months and at one year.

    RESULTS: One hundred participants (64 women, 36 men, age 58±11 years) were included in the programme. Compared with the baseline, significant and favourable changes in reported lifestyle habits were noted. Exercise levels were higher after one year and sedentary time decreased from 7.4 to 6.3 h/day. Dietary habits improved and the number of participants with a high consumption of alcohol decreased. Quality of life improved after one year.

    CONCLUSIONS: Participating in a structured lifestyle programme resulted in improved lifestyle habits and quality of life over one year in people with increased cardiovascular risk. Components such as an inter-professional teamwork, a focus on lifestyle rather than the disease, and combining individual visits and group sessions, might be central to the positive outcome of the programme.

  • 27.
    Linehan, Christine
    et al.
    UCD Centre for Disability Studies, University College Dublin, Ireland.
    Araten-Bergam, Tal
    La Trobe University, Australia.
    Baumbusch, Jennifer
    University of British Columbia, Canada.
    Beadle-Brown, Julie
    University of Kent, United Kingdom.
    Bigby, Christine
    La Trobe University, Australia.
    Birkbeck, Gail
    University College Cork, Ireland.
    Bradley, Valerie
    Human Services Research Institute, Cambridge, USA.
    Brown, Michael
    Queen's University, Belfast, United Kingdom.
    Bredewold, Femmianne
    University of Humanistic Studies, the Netherlands.
    Chirwa, Masauso
    University of Zambia, Zambia.
    Cui, Jialiang
    The Chinese University of Hong Kong, Hong Kong.
    Godoy Gimenez, Marta
    University of Almeria, Spain.
    Gomiero, Tiziano
    ANFFAS Trentino Onlus DAD© Project Group, Italy.
    Kanova, Sarka
    University of West Bohemia, the Czech Republic.
    Kroll, Thilo
    University College Dublin, Ireland.
    MacLachlan, Mac
    Maynooth University, Ireland.
    Mirfin-Veitch, Brigit
    Donald Beasley Institute, New Zealand.
    Narayan, Jayanthi
    University of Northampton, United Kingdom.
    Nearchou, Finiki
    University College Dublin, Ireland.
    Nolan, Adam
    University College Dublin, Ireland.
    O'Donovan, Mary-Ann
    University of Sydney, Australia.
    Santos, Flávia H.
    University College Dublin, Ireland.
    Šiška, Jan
    Charles University, the Czech Republic.
    Stainton, Tim
    University of British Columbia, Canada.
    Tideman, Magnus
    Ersta Sköndal Bräcke University College, Department of Social Sciences. Högskolan i Halmstad.
    Tossebro, Jan
    Norwegian University of Science and Technology, Norway.
    COVID-19 IDD: A global survey exploring family members' and paid staff's perceptions of the impact of COVID-19 on individuals with intellectual and developmental disabilities and their caregivers2020In: HRB open research, ISSN 2515-4826, Vol. 3, article id 39Article in journal (Refereed)
    Abstract [en]

    Background: This protocol outlines research to explore family members' and paid staff's perceptions of the impact of COVID-19 on individuals with intellectual and developmental disabilities and their caregivers. Evidence suggests that people with intellectual and developmental disabilities experience disparities in healthcare access and utilisation. This disparity was evident early in the pandemic when discussions arose regarding the potential exclusion of this population to critical care.

    Methods: An anonymous online survey will be conducted with caregivers, both family members and paid staff, to explore their perceptions of the impact of COVID-19 in terms of demographics, living arrangements, access to services, social distancing, and carer wellbeing. The survey will be developed by the research team, many of whom are experts in intellectual disability within their own jurisdictions. Using back-translation our team will translate the survey for distribution in 18 countries worldwide for international comparison. The survey team have extensive personal and professional networks and will promote the survey widely on social media with the support of local disability and advocacy agencies. Statistical descriptive and comparative analyses will be conducted. Ethical approval has been obtained for this study from University College Dublin's Human Research Ethics Committee (HS-20-28-Linehan).

    Dissemination: Study findings will be prepared in a number of formats in order to meet the needs of different audiences. Outputs will include academic papers, lessons learned paper, practice guidelines, reports, infographics and video content. These outputs will be directed to families, frontline and management delivering disability services, national-level policy makers, healthcare quality and delivery authorities, national pandemic organisations and international bodies.

  • 28.
    Linehan, Christine
    et al.
    University College Dublin, Ireland.
    Birkbeck, Gail
    University College Dublin, Ireland; University College Cork, Ireland.
    Araten-Bergman, Tal
    La Trobe University, Australia.
    Baumbusch, Jennifer
    University of British Columbia, Canada.
    Beadle-Brown, Julie
    University of Kent, United Kingdom.
    Bigby, Christine
    La Trobe University, Australia.
    Bradley, Valerie
    Human Services Research Institute, USA.
    Brown, Michael
    Queen's University, Belfast, United Kingdom.
    Bredewold, Femmianne
    University of Humanistic Studies, the Netherlands.
    Chirwa, Masauso
    University of Zambia, Zimbabwe.
    Cui, Jialiang
    The Chinese University of Hong Kong, Hong Kong.
    Godoy Gimenez, Marta
    University of Almeria, Spain.
    Gomeiro, Tiziano
    ANFFAS Trentino Onlus DAD© Project Group, Italy.
    Kanova, Šárka
    University of West Bohemia, the Czech Republic.
    Kroll, Thilo
    University College Dublin, Ireland.
    Li, Henan
    Human Services Research Institute, USA.
    MacLachlan, Mac
    Maynooth University, Ireland.
    Narayan, Jayanthi
    University of Northampton, United Kingdom.
    Nearchou, Finiki
    University College Dublin, Ireland.
    Nolan, Adam
    University College Dublin, Ireland.
    O'Donovan, Mary-Ann
    University of Sydney, Australia.
    Santos, Flavia H.
    University College Dublin, Ireland.
    Šiška, Jan
    Charles University, the Czech Republic.
    Stainton, Tim
    University of British Columbia, Canada.
    Tideman, Magnus
    Marie Cederschiöld University, Department of Social Sciences. Högskolan i Halmstad.
    Tossebro, Jan
    Norwegian University of Science and Technology, Norway.
    COVID-19 IDD: Findings from a global survey exploring family members' and paid staff's perceptions of the impact of COVID-19 on individuals with intellectual and developmental disabilities (IDD) and their caregivers.2022In: HRB open research, ISSN 2515-4826, Vol. 5, article id 27Article in journal (Refereed)
    Abstract [en]

    Background: A growing body of evidence attests to the disproportionate impact of COVID-19 on persons with intellectual and developmental disabilities (IDD) during the pandemic. This study asked caregivers about their perceptions of how COVID-19 impacted them and the people they support.

    Method: An online survey was conducted in 12 countries during August-September 2020 and sought information on demographics, support practices, information and training, experiences of COVID-19, social distancing, and wellbeing, as measured by the DASS12. This study reports on 3,754 family members, direct support professionals, and managers who participated in the survey.

    Results: Caregivers observed increases in depression/anxiety, stereotyped behaviours, aggression towards others and weight gain in the person(s) they supported. They also reported difficulties supporting the person(s) to access healthcare.  Families reported reducing or ceasing employment and absorbed additional costs when supporting their family member. Direct support professionals experienced changes in staff shifts, staff absences, increased workload and hiring of casual staff. Caregivers' wellbeing revealed high levels of stress, depression, and less so anxiety. The strongest predictor of wellbeing among families was observation of changes in mood in the person(s) they supported, while for direct support professionals, the strongest predictors of wellbeing were reorganisation of staff shifts and increases in new direct support staff.

    Discussion: Findings support the contention of this population experiencing a disproportionate burden during the COVID-19 pandemic, reflecting historical inequities in access to healthcare and other human rights violations which are now protected under the United Nations Convention on the Rights of Persons with Disabilities.

  • 29.
    Mankell, Anna
    et al.
    Marie Cederschiöld University, Institutionen för civilsamhälle och religion, Centre for Civil Society Research.
    Abdelzadeh, Ali
    Marie Cederschiöld University, Institutionen för civilsamhälle och religion, Centre for Civil Society Research.
    The role of community trust for compliance with the Swedish COVID-19 immunisation programme2023In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 51, no 5, p. 704-710, article id 14034948221145780Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS: During the COVID-19 pandemic, vaccination as an important and engaging topic once again entered the public debate in many countries, including Sweden. In particular, the varying degree to which different social groups tend to choose to get vaccinated was raised as a point of discussion on the agenda. Thus, the aim of this study was to investigate the role of various forms of trust, especially community trust, in the explanation of vaccine coverage in the Swedish COVID-19 immunisation programme.

    METHODS: In this study, individual survey data from the Swedish Trust Barometer were aggregated and combined with socio-demographic register-based data at Regional Statistical Areas (RegSO) to examine the relationship between trust and vaccine coverage at the local community level.

    RESULTS: The results showed that both generalised and institutional trust seemed to be essential when it comes to explaining vaccination coverage. In addition, we showed that community trust, that is, trust in neighbours and people living in the neighbourhood, was an even stronger factor when it comes to explaining vaccination coverage at the local level.

    CONCLUSIONS: This article contributes to the literature on trust in relation to health care by identifying a new dimension of trust with significance to immunisation that is worthy of future scholarly attention.

  • 30.
    Mankell, Anna
    et al.
    Marie Cederschiöld University, Institutionen för civilsamhälle och religion.
    Nilson, Finn
    Marie Cederschiöld University, Institutionen för civilsamhälle och religion, Centre for Civil Society Research. Centre for Societal Risk Research, Karlstad University, Karlstad, Sweden; Department of Political, Historical, Religious and Cultural Studies, Karlstad University, Karlstad, Sweden.
    A Study of Differences in the Perceived Risk of Attaining a Residential Fire Injury2023In: Fire technology, ISSN 0015-2684, E-ISSN 1572-8099, Vol. 59, p. 1789-1804Article in journal (Refereed)
    Abstract [en]

    Certain groups (e.g., those of higher age, lower educational attainment,lower income, living alone, immigrants, etc.) have a greater risk of residential firemortality. Previous research has also shown that individuals belonging to high-riskgroups have generally lower levels of fire protection, and it has been suggested thatthis is due to a lower risk perception in this group. As such, this study investigateshow the perceived risk of being injured in a residential fire varies in the Swedish population. The results show that risk perception varies in the Swedish populationdepending upon sociodemographic factors. When the different sociodemographic factors are controlled against each other, women, individuals with a low educationallevel, individuals living in rural communities and individuals born outside of the Nordic countries consistently experience their risk to be higher. With the exception ofwomen, the results show that high-risk individuals have a high risk perception. Theseresults are important as they indicate that it is not a lack of risk awareness that is thereason why high-risk groups are less inclined to implement fire safety practices.

  • 31.
    Mattsson, Elisabet
    et al.
    Marie Cederschiöld University, Department of Health Care Sciences. Uppsala universitet.
    Lindblad, Marléne
    Röda Korsets Högskola.
    Kneck, Åsa
    Marie Cederschiöld University, Department of Health Care Sciences.
    Salzmann-Eriksson, Martin
    Högskolan i Gävle.
    Klarare, Anna
    Marie Cederschiöld University, Department of Health Care Sciences. Uppsala universitet.
    Voices of women in homelessness during the outbreak of the COVID-19 pandemic: A co-created qualitative study2023In: BMC Women's Health, E-ISSN 1472-6874, Vol. 23, no 11Article in journal (Refereed)
    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.

  • 32.
    Nilson, Finn
    et al.
    Karlstads universitet.
    Lundgren, Linnea
    Ersta Sköndal Bräcke University College, Centre for Civil Society Research.
    Bonander, Carl
    Karlstads universitet; Göteborgs universitet.
    Living arrangements and fire-related mortality amongst older people in Europe2020In: International Journal of Injury Control and Safety Promotion, ISSN 1745-7300, E-ISSN 1745-7319, Vol. 27, no 3, p. 378-384Article in journal (Refereed)
    Abstract [en]

    In Europe, a demographic transition has occurred meaning that countries have larger older adult populations who are increasingly living alone and receiving homecare rather than institutional care. Given that living alone is the greatest individual risk factor for fire mortality amongst older adults and that large differences exist in terms of both fire mortality risk and living arrangements between countries, this study investigates the association between co-living rates and fire mortality rates among older adults in Europe. Freely available datasets with aggregated European data on fire mortality, living arrangements among older adults, population statistics and GDP were analyzed using Poisson regression models. The results show that fire-related mortality rates amongst older adults in Europe is correlated with living arrangements after adjusting for GDP. Specifically, in Europe, when the share of older adults living alone increases by one percentage point, fire mortality rates increase by roughly 4 percent for both sexes.

  • 33.
    O'Sullivan, Anna
    Marie Cederschiöld University, Department of Health Care Sciences, Palliative Research Centre, PRC.
    Undocumented migrants’ access to healthcare in Sweden, and the impact of Act 2013:4072023In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989Article in journal (Refereed)
    Abstract [en]

    Background Research shows that undocumented migrants have difficulties in accessing healthcare. Act 2013:407 came into force in 2013 and entitled undocumented migrants to healthcare that cannot be deferred. To date, studies about undocumented migrants’ access to care in Sweden and the impact of Act 2013:407 are sparse. Hence, the aim of this study was to describe professionals’ experiences of access to healthcare for undocumented migrants in Sweden and the impact of Act 2013:407.

    Methods A qualitative design with semi-structured interviews was employed. Nine interviews were carried out in 2015 with nurses at two NGO healthcare centres for undocumented migrants – and an additional seven interviews in 2022 with staff at an NGO healthcare centre for undocumented migrants and personnel at a regional health and medical care administration. Interpretive description was used for the analyses.

    Ethical considerations Permission to carry out the study was obtained from managers at the participating NGOs and the regional health and medical care administration. Participants received verbal and written information about the study, and informed consent was obtained from all participants.

    Findings Six categories emerged from the analysis: Changes since the Act was introduced, General problems with healthcare access, Care for undocumented migrants – politics and social economy, Lack of knowledge, ‘Healthcare that cannot be deferred’ and Being an undocumented migrant.

    Conclusion Undocumented migrants’ social needs are as great as their needs for healthcare. Healthcare staff are burdened with healthcare cost considerations which affect their judgement of care provision and prioritization. Healthcare staff attitudes towards undocumented migrants affect their access to healthcare. Undocumented migrants in need of healthcare are especially vulnerable due to their legal status, being ill and the fear of being reported and deported. To assure undocumented migrants’ access to healthcare and maintain healthcare ethics, the only possible solution is to provide healthcare based on needs.

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  • 34.
    Rovner, Graciela S
    et al.
    Göteborgs universitet; Karolinska institutet.
    Sunnerhagen, Katharina S
    Göteborgs universitet.
    Björkdahl, Ann
    Ersta Sköndal Bräcke University College, Department of Social Sciences. Göteborgs universitet.
    Gerdle, Björn
    Linköpings universitet.
    Börsbo, Björn
    Linköpings universitet; Länssjukhuset Ryhov; Region Jönköpings län.
    Johansson, Fredrik
    Danderyds sjukhus.
    Gillanders, David
    United Kingdom.
    Chronic pain and sex-differences; women accept and move, while men feel blue2017In: PLOS ONE, E-ISSN 1932-6203, Vol. 12, no 4, article id e0175737Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of this study is to explore differences between male and female patients entering a rehabilitation program at a pain clinic in order to gain a greater understanding of different approaches to be used in rehabilitation.

    METHOD: 1371 patients referred to a specialty pain rehabilitation clinic, completed sociodemographic and pain related questionnaires. They rated their pain acceptance (CPAQ-8), their kinesiophobia (TSK), the impact of pain in their life (MPI), anxiety and depression levels (HAD) and quality of life scales: the SF-36, LiSat-11, and the EQ-5D. Because of the large sample size of the study, the significance level was set at the p ≤.01.

    RESULTS: Analysis by t-test showed that when both sexes experience the same pain severity, women report significantly higher activity level, pain acceptance and social support while men report higher kinesiophobia, mood disturbances and lower activity level.

    CONCLUSION: Pain acceptance (CPAQ-8) and kinesiophobia (TSK) showed the clearest differences between men and women. Pain acceptance and kinesiophobia are behaviorally defined and have the potential to be changed.

  • 35. Sermeus, Walter
    et al.
    Aiken, Linda H
    Van den Heede, Koen
    Rafferty, Anne Marie
    Griffiths, Peter
    Moreno-Casbas, Maria Teresa
    Busse, Reinhard
    Lindqvist, Rikard
    Ersta Sköndal University College.
    Scott, Anne P
    Bruyneel, Luk
    Brzostek, Tomasz
    Kinnunen, Juha
    Schubert, Maria
    Schoonhoven, Lisette
    Zikos, Dimitrios
    Nurse forecasting in Europe (RN4CAST): Rationale, design and methodology.2011In: BMC Nursing, E-ISSN 1472-6955, Vol. 10, p. 6-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Current human resources planning models in nursing are unreliable and ineffective as they consider volumes, but ignore effects on quality in patient care. The project RN4CAST aims innovative forecasting methods by addressing not only volumes, but quality of nursing staff as well as quality of patient care.

    METHODS/DESIGN: A multi-country, multilevel cross-sectional design is used to obtain important unmeasured factors in forecasting models including how features of hospital work environments impact on nurse recruitment, retention and patient outcomes. In each of the 12 participating European countries, at least 30 general acute hospitals were sampled. Data are gathered via four data sources (nurse, patient and organizational surveys and via routinely collected hospital discharge data). All staff nurses of a random selection of medical and surgical units (at least 2 per hospital) were surveyed. The nurse survey has the purpose to measure the experiences of nurses on their job (e.g. job satisfaction, burnout) as well as to allow the creation of aggregated hospital level measures of staffing and working conditions. The patient survey is organized in a sub-sample of countries and hospitals using a one-day census approach to measure the patient experiences with medical and nursing care. In addition to conducting a patient survey, hospital discharge abstract datasets will be used to calculate additional patient outcomes like in-hospital mortality and failure-to-rescue. Via the organizational survey, information about the organizational profile (e.g. bed size, types of technology available, teaching status) is collected to control the analyses for institutional differences.This information will be linked via common identifiers and the relationships between different aspects of the nursing work environment and patient and nurse outcomes will be studied by using multilevel regression type analyses. These results will be used to simulate the impact of changing different aspects of the nursing work environment on quality of care and satisfaction of the nursing workforce.

    DISCUSSION: RN4CAST is one of the largest nurse workforce studies ever conducted in Europe, will add to accuracy of forecasting models and generate new approaches to more effective management of nursing resources in Europe.

  • 36.
    Svedin, Carl Göran
    et al.
    Marie Cederschiöld University, Department of Social Sciences.
    Donevan, Meghan
    Marie Cederschiöld University, Department of Social Sciences.
    Bladh, Marie
    Linköpings universitet.
    Priebe, Gisela
    Lunds universitet; Karlstads universitet.
    Fredlund, Cecilia
    Linköpings universitet.
    Jonsson, Linda Sofia
    Marie Cederschiöld University, Department of Social Sciences.
    Associations between adolescents watching pornography and poor mental health in three Swedish surveys2023In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 32, p. 1765-1780Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to examine the association between watching pornography and poor mental health in three repeated cross-sectional surveys in Sweden (2004, 2009, 2014) among high school seniors (13,277 students) with an average age of 18 years. The same index questions concerning ever having watched pornography and the frequency of watching pornography during the last year were combined with three different measures of psychological health and background control variables in multiple logistic regression and forward stepwise logistic regression models. The repeated cross-sectional surveys did not find any consistent associations across years between poor mental health and ever having watched pornography or the frequency of watching pornography. Having watched deviant pornography (containing violence, children and/or animals) was associated with poor mental health among boys in two surveys but only in one survey among girls. Other characteristics, such as mother's unemployment (especially boys), parenting style (especially high controlling parents among boys) and experiences of sexual abuse (especially penetrating abuse among girls), were more consistently and strongly associated to poor mental health across the three surveys. This study stresses the importance of controlling for multiple background variables when studying the association between watching pornography and mental health, since the association might primarily be explained by underlying confounding variables.

  • 37.
    Timpka, Toomas
    et al.
    Linköpings universitet.
    Dahlström, Örjan
    Linköpings universitet.
    Fagher, Kristina
    Linköpings universitet; Lunds universitet.
    Adami, Paolo Emilio
    World Athletics, Monaco; University of Rome, Italy.
    Andersson, Christer
    Linköpings universitet.
    Jacobsson, Jenny
    Linköpings universitet.
    Svedin, Carl Göran
    Marie Cederschiöld University, Department of Social Sciences. Linköpings universitet.
    Bermon, Stéphane
    World Athletics, Monaco; Université Côte d'Azur, France.
    Vulnerability and stressors on the pathway to depression in a global cohort of young athletics (track and field) athletes2022In: Scientific Reports, E-ISSN 2045-2322, Vol. 12, no 1, article id 7901Article in journal (Refereed)
    Abstract [en]

    This research set out to identify pathways from vulnerability and stressors to depression in a global population of young athletes. Retrospective data were collected at age 18-19 years from Athletics athletes (n = 1322) originating from Africa, Asia, Europe, Oceania, and the Americas. We hypothesised that sports-related and non-sports-related stressors in interaction with structural vulnerability instigate depression. Path modelling using Maximum likelihood estimation was employed for the data analysis. Depression caseness and predisposition were determined using the WHO-5 instrument. Thirty-six percent of the athletes (n = 480) returned complete data. Eighteen percent of the athletes reported lifetime physical abuse, while 11% reported sexual abuse. Forty-five percent of the athletes had recently sustained an injury. The prevalence of depression caseness was 5.6%. Pathways to depression caseness were observed from female sex (p = 0.037) and injury history (p = 0.035) and to predisposition for depression also through exposure to a patriarchal society (p = 0.046) and physical abuse (p < 0.001). We conclude that depression in a global population of young athletes was as prevalent as previously reported from general populations, and that universal mental health promotion in youth sports should include provision of equal opportunities for female and male participants, injury prevention, and interventions for abuse prevention and victim support.

  • 38.
    Wiklund, Susanne
    et al.
    Stockholms läns landsting; Karolinska institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    Örtqvist, Åke
    Karolinska institutet; Stockholms läns landsting.
    Broliden, Kristina
    Karolinska institutet.
    Tammelin, Ann
    Stockholms läns landsting; Karolinska institutet.
    Acquisition of extended spectrum β-lactamases during travel abroad: A qualitative study among Swedish travellers examining their knowledge, risk assessment, and behaviour2016In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, p. 32378-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Travel to foreign countries involves the risk of becoming a carrier of antibiotic-resistant bacteria, especially when the destination is a country with a high prevalence of this type of bacteria.

    AIM AND METHODS: The aim of this study was to learn about the knowledge of antibiotic resistance, and the behaviour and risk-taking among travellers, who had become carriers of extended spectrum beta-lactamases (ESBL)-producing bacteria during travel to a high-prevalence country. A modified version of grounded theory was used to analyse 15 open interviews.

    RESULTS: The analysis resulted in a core category: A need for knowledge to avoid risk-taking. Before the journey, the participants did not perceive there to be any risk of becoming a carrier of antibiotic- resistant bacteria. The low level of knowledge of antibiotic-resistant bacteria and transmission routes influenced their behaviour and risk-taking during their journey, resulting in them exposing themselves to risk situations. After their trip, the majority did not believe that their personal risk behaviour could have caused them to become carriers of ESBL.

    CONCLUSION: The participants' lack of knowledge of antibiotic-resistant bacteria resulted in unconscious risk-taking during their journey, which may have resulted in becoming carriers of ESBL-producing bacteria.

  • 39.
    Wiklund, Susanne
    et al.
    Stockholms läns landsting; Karolinska institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet.
    Örtqvist, Åke
    Karolinska institutet; Stockholms läns landsting.
    Broliden, Kristina
    Karolinska institutet.
    Tammelin, Ann
    Karolinska institutet.
    Staff experiences of caring for patients with extended-spectrum β-lactamase–producing bacteria: A qualitative study2015In: American Journal of Infection Control, ISSN 0196-6553, E-ISSN 1527-3296, Vol. 43, no 12, p. 1302-1309Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Patients who become carriers of antibiotic-resistant bacteria are sometimes stigmatized by health professionals. Staff members' fears of becoming infected could affect their willingness to care for these patients.

    METHODS:The purpose of this study was to increase the knowledge of what it means for staff in acute care settings and nursing homes to care for patients with extended-spectrum β-lactamase (ESBL)-producing bacteria. Assistant nurses, registered nurses, and physicians from acute care settings and nursing homes were interviewed. A modified version of Grounded Theory was used for the analysis.

    RESULTS:The analysis resulted in the core category "to operate as an expert in a chaotic environment" in acute care settings. Despite a lack of resources, hospital staff try to provide the best possible care for patients with ESBL. The analysis of the interviews in the nursing homes resulted in the core category "the employee who, despite uncertainty, provides good care." Despite some fear, and a lack of knowledge, the study participants tried to provide the residents with good care.

    CONCLUSION: Staff in acute care settings and nursing homes must have adequate knowledge and reasonable working conditions to be able to provide high-quality care for patients and residents who are ESBL carriers.

  • 40.
    Wiklund, Susanne
    et al.
    Stockholms läns landsting; Karolinska institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    Örtqvist, Åke
    Karolinska institutet; Stockholms läns landsting.
    Vading, Malin
    Karolinska institutet.
    Giske, Göran
    Karolinska institutet.
    Broliden, Kristina
    Karolinska institutet.
    Tammelin, Ann
    Stockholms läns landsting; Karolinska institutet.
    Knowledge and understanding of antibiotic resistance and the risk of becoming a carrier when travelling abroad: A qualitative study of Swedish travelers2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 3, p. 302-308Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Increasing globalisation, with the migration of people, animals and food across national borders increases the risk of the spread of antibiotic-resistant bacteria. To avoid becoming a carrier of antibiotic-resistant bacteria when travelling, knowledge about antibiotic resistance is important.

    MATERIALS AND METHODS: We aimed to describe the knowledge and understanding of antibiotic-resistant bacteria, and of the risk for becoming a carrier of such bacteria, among Swedish travellers before their travel to high-risk areas. A questionnaire with three open-ended questions was distributed to 100 individuals before departure.

    RESULTS: The travellers' answers were analysed using content analysis, resulting in the theme 'To be an insecure traveller who takes control over one's own journey'. Our results showed that the travellers were aware of what the term 'antimicrobial resistance' meant, but did not understand its real significance, nor the consequences for the individual nor for society. They also distanced themselves from the problem. Few thought that their travel would entail a risk of becoming a carrier of resistant bacteria. The lack of knowledge caused an uncertainty among the travellers, whom tried to master the situation by using coping strategies. They proposed a number of measures to prevent carriership. The measures were general and primarily aimed at avoiding illness abroad, particularly acute gastro-intestinal infection.

    CONCLUSIONS: In health care and vaccination clinics, there is a need for improved information for persons intending to travel to high-risk areas, both about the risks of contracting antibiotic-resistant bacteria and about effective preventive measures.

  • 41.
    Zetterqvist, Maria
    et al.
    Region Östergötland; Linköpings universitet.
    Landberg, Åsa
    Marie Cederschiöld University, Department of Social Sciences.
    Jonsson, Linda
    Marie Cederschiöld University, Department of Social Sciences.
    Svedin, Carl Göran
    Marie Cederschiöld University, Department of Social Sciences.
    The psychosocial consequences of covid-19 in adolescents with nonsuicidal self-injury2023In: Child and Adolescent Psychiatry and Mental Health, E-ISSN 1753-2000, Vol. 17, no 1, article id 33Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Young people have been especially affected by the psychosocial consequences of the covid-19 pandemic. Covid-19 has potentially also been more stressful for vulnerable groups with mental health problems.

    METHODS: In this cross-sectional study, the psychosocial effects of covid-19 in a vulnerable group of adolescents with nonsuicidal self-injury (NSSI) from a sample of 1602 Swedish high-school students were examined. Data were collected in 2020 and 2021. First, adolescents with and without NSSI were compared on how they perceived the psychosocial impact of covid-19, and second, a hierarchical multiple regression analysis was used to examine whether lifetime NSSI experience was associated with perceived psychosocial consequences of covid-19, when demographic variables and symptoms of mental health problems were controlled for. Interaction effects were also examined.

    RESULTS: Significantly more individuals with NSSI reported being burdened by covid-19 compared to those without NSSI. When demographic variables and mental health symptoms were controlled for, adding NSSI experience did not, however, increase the amount of variance explained in the model. The total model explained 23.2% of the variance in perceived psychosocial impact of covid-19. Perceiving the family's financial situation as poor and neither good nor bad, studying a theoretical high school program, symptoms of depression and difficulties with emotion regulation were significantly associated with perceived negative psychosocial impact of the covid-19 pandemic. There was a significant interaction effect between NSSI experience and depressive symptoms. The effect of NSSI experience was larger when depressive symptoms were lower.

    CONCLUSIONS: Lifetime NSSI experience in itself was not associated with psychosocial covid-19 consequences when other variables were controlled for, whereas symptoms of depression and difficulties with emotion regulation were. Results imply that vulnerable adolescents with mental health symptoms need special attention and access to mental health support in order to prevent further stress and worsening of mental health symptoms in the wake of the covid-19 pandemic.

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  • 42.
    Öhlén, Joakim
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Göteborgs universitet.
    Cohen, Joachim
    Vrije Universiteit Brussel (VUB), Belgium; Ghent University, Belgium.
    Håkanson, Cecilia
    Ersta Sköndal University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet.
    Determinants in the place of death for people with different cancer types: A national population-based study2017In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 56, no 3, p. 455-461Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Place of death has for the past decade increasingly come to be regarded as a robust indicator of how palliative care is organized and provided, and is also recognized as an important factor for well being at the end of life. Variations in place of cancer deaths have previously been reported in the context of country-specific healthcare organization, but without differentiating between cancer types and national regional variations. Our aim was to examine, at a population level, where people with cancer diseases die in Sweden, and to investigate associations of place of death and cancer type with individual, socioeconomic and geographical characteristics of the deceased.

    MATERIAL AND METHODS: This population level study is based on death certificate data (sex; age; underlying cause of death and place of death) and population register data (educational attainment, marital status, living arrangements, area of residence, degree of urbanization, and healthcare region) of all 2012 cancer deaths in Sweden, with a registered place of death (hospital, nursing home, home, other places). Data were explored descriptively. To investigate associations between place of death and cancer types, and individual, socioeconomic and environmental characteristics, a series of multivariable logistic regression analyses were performed.

    RESULTS: The most frequent type of cancer death occurring at home was upper gastrointestinal cancer (25.6%) and the least frequent was hematological cancer (15.2%). Regional variations in cancer deaths occurring at home ranged from 17.1% to 28.4%. Factors associated with place of death by cancer type were age, educational attainment, marital status, healthcare regions and degree of urbanization.

    CONCLUSION: Large healthcare regional variations in place of death among different cancer types were found. The socioeconomic inequality previously demonstrated for screening, diagnostic and treatment processes, rehabilitation and survival thus also seems to be reflected in the place of death.

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