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  • 1.
    Audulv, Åsa
    et al.
    Umeå universitet.
    Hall, Elisabeth O. C.
    Aarhus University, Denmark; University of Faroe Islands, Denmark.
    Kneck, Åsa
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Westergren, Thomas
    University of Agder, Norway; University of Stavanger, Norway.
    Fegran, Liv
    University of Agder, Norway.
    Pedersen, Mona Kyndi
    North Denmark Regional Hospital, Denmark; Aalborg University, Denmark.
    Aagaard, Hanne
    Lovisenberg Diaconale Univeristy of College, Norway.
    Dam, Kristianna Lund
    University of Faroe Islands, Denmark.
    Ludvigsen, Mette Spliid
    Aarhus University, Denmark; Nord University, Norway.
    Qualitative longitudinal research in health research: A method study2022Ingår i: BMC Medical Research Methodology, E-ISSN 1471-2288, Vol. 22, nr 1, artikel-id 255Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background: Qualitative longitudinal research (QLR) comprises qualitative studies, with repeated data collection, that focus on the temporality (e.g., time and change) of a phenomenon. The use of QLR is increasing in health research since many topics within health involve change (e.g., progressive illness, rehabilitation). A method study can provide an insightful understanding of the use, trends and variations within this approach. The aim of this study was to map how QLR articles within the existing health research literature are designed to capture aspects of time and/or change.

    Methods: This method study used an adapted scoping review design. Articles were eligible if they were written in English, published between 2017 and 2019, and reported results from qualitative data collected at different time points/time waves with the same sample or in the same setting. Articles were identified using EBSCOhost. Two independent reviewers performed the screening, selection and charting.

    Results: A total of 299 articles were included. There was great variation among the articles in the use of methodological traditions, type of data, length of data collection, and components of longitudinal data collection. However, the majority of articles represented large studies and were based on individual interview data. Approximately half of the articles self-identified as QLR studies or as following a QLR design, although slightly less than 20% of them included QLR method literature in their method sections.

    Conclusions: QLR is often used in large complex studies. Some articles were thoroughly designed to capture time/change throughout the methodology, aim and data collection, while other articles included few elements of QLR. Longitudinal data collection includes several components, such as what entities are followed across time, the tempo of data collection, and to what extent the data collection is preplanned or adapted across time. Therefore, there are several practices and possibilities researchers should consider before starting a QLR project.

  • 2.
    Audulv, Åsa
    et al.
    Mittuniversitetet.
    Kneck, Åsa
    Ersta Sköndal högskola, Institutionen för vårdvetenskap.
    Symposium Abstract #1: How do we understand time and change?: Five approaches to longitudinal qualitative research in nursing2016Ingår i: Abstracts, Oral Presentations for Qualitative Methods Conference, May 2016: Symposium: Longitudinal Qualitative Analysis—How Can It Be Done?, 2016, s. 4-4Konferensbidrag (Refereegranskat)
    Abstract [en]

    Longitudinal qualitative research can give us new insights in social processes and experiences over time. In recent years, there has been a growing interest in conducting longitudinal qualitative research. However, the definition of what constitutes a longitudinal data presentation is unclear, the methodological literature scarce, and the variation of procedures great. Therefore, we undertook a review of longitudinal qualitative articles within the nursing field to identify and describe various types of qualitative longitudinal approaches. In this presentation, the five identified types of longitudinal qualitative approaches will be presented. In total, a large part of the papers described as having a longitudinal design in fact only performed a longitudinal data collection and did not integrate ideas of time or change in their analysis or results. This practice will be problematized and a definition for longitudinal qualitative research will be proposed. Three fruitful approaches to analyzing longitudinal qualitative data were identified: pool-, phase-, and pattern-oriented approaches. These practices focus upon different aspects of time, change, process, and context, thus presenting different kinds of results. A discussion of the pros and cons of these three practices will be held so researchers can make a more informed decision when choosing which approach they will take when analyzing longitudinal material.

  • 3.
    Audulv, Åsa
    et al.
    Mittuniversitetet.
    Kneck, Åsa
    Ersta Sköndal högskola, Institutionen för vårdvetenskap.
    Symposium Abstract #2: Longitudinal Qualitative Analysis: A Practical Guide to a Pattern-Oriented Analysis Approach2016Ingår i: Abstracts, Oral Presentations for Qualitative Methods Conference, May 2016: Symposium: Longitudinal Qualitative Analysis—How Can It Be Done?, 2016, s. 4-4Konferensbidrag (Refereegranskat)
    Abstract [en]

    Despite the fact that longitudinal qualitative research has attained more attention over the last couple of years, there is little literature about the procedures of doing qualitative longitudinal analysis. This presentation will focus upon procedures of conducting a pattern-oriented longitudinal analysis. A pattern-oriented analysis focuses upon how individuals (or phenomena) move through a process/time in identifiable patterns. While other longitudinal analysis approaches might emphasize a main process, a pattern-oriented approach accounts for the individual variance in the context of time and change. We developed the pattern-oriented analysis approach after conducting two independent qualitative longitudinal studies concerning learning and enacting self-management in the context of chronic conditions. Examples from these studies will be discussed during the presentation. Both analyses were performed in several steps where the following key features included: “identifying the process,” “summarized description,” and “using matrixes.” The key features of the analysis procedure will be presented as well as pitfalls and possible solutions related to the approach.

  • 4.
    Audulv, Åsa
    et al.
    Department of Nursing, Umeå University, Umeå, Sweden.
    Westergren, Thomas
    Department of Health and Nursing Science, University of Agder, Kristiansand, Norway; Department of Public Health, University of Stavanger, Stavanger, Norway.
    Ludvigsen, Mette Spliid
    Department of Clinical Medicine, Randers Regional Hospital, Aarhus University, Aarhus, Denmark; Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
    Pedersen, Mona Kyndi
    Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
    Fegran, Liv
    Department of Health and Nursing Science, University of Agder, Kristiansand, Norway.
    Hall, Elisabeth O. C.
    Faculty of Health, Aarhus University, Aarhus, Denmark; Faculty of Health Sciences and Nursing, University of Faroe Islands, Torshavn, Faroe Islands.
    Aagaard, Hanne
    Lovisenberg Diaconal University College, Oslo, Norway.
    Robstad, Nastasja
    Department of Health and Nursing Science, University of Agder, Kristiansand, Norway.
    Kneck, Åsa
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap. Marie Cederschiöld högskola.
    Time and change: A typology for presenting research findings in qualitative longitudinal research2023Ingår i: BMC Medical Research Methodology, E-ISSN 1471-2288, Vol. 23, artikel-id 284Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Qualitative longitudinal research (QLR) is an emerging methodology used in health research. The method literature states that the change in a phenomenon through time should be the focus of any QLR study, but in empirical studies, the analysis of changes through time is often poorly described, and the emphasis on time/change in the findings varies greatly. This inconsistency might depend on limitations in the existing method literature in terms of describing how QLR studies can present findings. The aim of this study was to develop and describe a typology of alternative approaches for integrating time and/or change in QLR findings.

    Methods In this method study, we used an adapted scoping review design. Articles were identified using EBSCOhost. In total, methods and results sections from 299 QLR articles in the field of health research were analyzed with inspiration from content analysis.

    Results We constructed a typology of three types and seven subtypes. The types were based on the underlying structural principles of how time/change was presented: Type A) Findings have a low utilization of longitudinal data, Type B) Findings are structured according to chronological time, and Type C) Findings focus on changes through time. These types differed in 1) the way the main focus was on time, change or neither; 2) the level of interpretation in the findings; and 3) how theoretical understandings of time/change were articulated in the articles. Each type encompassed two or three subtypes that represented distinct approaches to the aim and results presentation of QLR findings.

    Conclusions This method study is the first to describe a coherent and comprehensive typology of alternative approaches for integrating time/change into QLR findings in health research. By providing examples of various subtypes that can be used for results presentations, it can help researchers make informed decisions suitable to their research intent.

  • 5.
    Bergman, Love
    et al.
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Britton, Asabea
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Kneck, Åsa
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Health-related stigma related to leprosy: What can be learned from nurses in Ghana?2018Ingår i: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 38, nr 2, s. 96-102Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the study was to describe nurses’ experiences of how stigma affected the care and health of patients with leprosy. Health-related stigma exists worldwide and affects patients, relatives and caregivers. Mere word ‘leprosy’ is often met with disgust, shame and fear. Knowledge of health-related stigma is important for developing care in different parts of the world. The study has a qualitative, descriptive design. Seven semi-structured individual interviews were conducted with nurses working at a hospital specializing in leprosy care. The study was carried out in the central region of Ghana. Data were analysed using qualitative content analysis. The findings are presented as one theme, ‘Increased knowledge and holistic interventions are important in care for patients with leprosy’, and three sub-themes: ‘knowledge and beliefs are intimately interlaced with leprosy-related stigma’, ‘information is important but not enough to change behaviours and attitudes’ and ‘long-term interventions in a social context’. We conclude that caring for patients with leprosy involved long-term interventions, not at least in relation to education on a society level as well as concerning patients’ abilities to learn a skill to make an income in order to be less dependent on healthcare facilities.

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  • 6.
    Bullington, Jennifer
    et al.
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Söderlund, Mona
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Bos Sparén, Elisabeth
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Kneck, Åsa
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Omérov, Pernilla
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Cronqvist, Agneta
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Communication skills in nursing: A phenomenologically-based communication training approach2019Ingår i: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 39, s. 136-141Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this article is to present a communication skills training curriculum for nursing students, based upon phenomenology. Research shows that nurses have difficulty prioritizing dialogue with patients, due to lack of time, organizational and cultural factors. Like other health care professionals, nurses may also have difficulties communicating with patients due to personal fears and shortcomings. The communication training curriculum based upon phenomenology aims at systematically training students to stay focused upon patients' and relatives' narratives, allowing them to reflect upon and better understand their current situation. This approach to communication is applicable in any clinical situation where it important to provide space for the patients' experiences. The philosophical principles guiding the training are presented here as well as the practical steps in the program. Finally, the approach is compared to other common communication methods used in nursing (motivational interviewing, caring conversations, empathy training). The authors hope that the article will highlight the nurses’ role as dialogue partner as well as emphasize the importance of communication skills training in nursing education. This approach can be refined, tested and modified in future research and may serve as an inspirational model for creating a generic communicative competence for nurses.

  • 7.
    Ekstedt, Mirjam
    et al.
    Karolinska institutet; Linnéuniversitetet.
    Kirsebom, Marie
    Linnéuniversitetet.
    Lindqvist, Gunilla
    Linnéuniversitetet.
    Kneck, Åsa
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Frykholm, Oscar
    Karolinska institutet.
    Flink, Maria
    Karolinska institutet; Karolinska universitetssjukhuset.
    Wannheden, Carolina
    Karolinska institutet.
    Design and Development of an eHealth Service for Collaborative Self-Management among Older Adults with Chronic Diseases: A Theory-Driven User-Centered Approach2021Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, nr 1, artikel-id 391Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The increasing prevalence of chronic conditions and multimorbidity poses great challenges to healthcare systems. As patients' engagement in self-managing their chronic conditions becomes increasingly important, eHealth interventions are a promising resource for the provision of adequate and timely support. However, there is inconclusive evidence about how to design eHealth services to meet the complex needs of patients. This study applied an evidence-based and theory-informed user-centered design approach in three phases to identify the needs of older adults and healthcare professionals in the collaborative management of multimorbidity (phase 1), develop an eHealth service to address these needs (phase 2), and test the feasibility and acceptance of the eHealth service in a clinical setting (phase 3). Twenty-two user needs were identified and a web-based application-ePATH (electronic Patient Activation in Treatment at Home)-with separate user interfaces for patients and healthcare professionals was developed. The feasibility study with two nurses and five patients led to a redesign and highlighted the importance of adequately addressing not only varying user needs but also the complex nature of healthcare organizations when implementing new services and processes in chronic care management.

  • 8.
    Ewertzon, Mats
    et al.
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Alvariza, Anette
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap, Palliativt forskningscentrum, PFC. Capio Palliativ vård Dalen, Stockholm.
    Winnberg, Elisabeth
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Leksell, Janeth
    Högskolan Dalarna; Uppsala universitet.
    Andershed, Birgitta
    Norway.
    Goliath, Ida
    Karolinska institutet; Ersta sjukhus.
    Momeni, Pardis
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Kneck, Åsa
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Skott, Maria
    Karolinska institutet; Norra Stockholms psykiatri, Stockholms läns landsting.
    Årestedt, Kristofer
    Linnéuniversitetet; Linköpings universitet; Länssjukhuset i Kalmar.
    Adaptation and evaluation of the Family Involvement and Alienation Questionnaire for use in the care of older people, psychiatric care, palliative care and diabetes care2018Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 74, nr 8, s. 1839-1850Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To adapt the Family Involvement and Alienation Questionnaire for use in the care of older people, psychiatric care, palliative care and diabetes care and to evaluate its validity and reliability.

    BACKGROUND: Involvement in the professional care has proven to be important for family members. However, they have described feelings of alienation in relation to how they experienced the professionals' approach. To explore this issue, a broad instrument that can be used in different care contexts is needed.

    DESIGN: A psychometric evaluation study, with a cross-sectional design.

    METHOD: The content validity of the Family Involvement and Alienation Questionnaire was evaluated during 2014 by cognitive interviews with 15 family members to adults in different care contexts. Psychometric evaluation was then conducted (2015-2016). A sample of 325 family members participated, 103 of whom in a test-retest evaluation. Both parametric and non-parametric methods were used.

    RESULTS: The content validity revealed that the questionnaire was generally understood and considered to be relevant and retrievable by family members in the contexts of the care of older people, psychiatric care, palliative care and diabetes care. Furthermore, the Family Involvement and Alienation Questionnaire (Revised), demonstrated satisfactory psychometric properties in terms of data quality, homogeneity, unidimensionality (factor structure), internal consistency and test-retest reliability.

    CONCLUSION: The study provides evidence that the Family Involvement and Alienation Questionnaire (Revised) is reliable and valid for use in further research and in quality assessment in the contexts of the care of older people, psychiatric care, palliative care and diabetes care. This article is protected by copyright. All rights reserved.

  • 9.
    Flink, Maria
    et al.
    Karolinska Institutet; Karolinska Universitetsjukhuset.
    Lindblad, Marléne
    Karolinska institutet; Kungliga Tekniska högskolan (KTH).
    Frykholm, Oscar
    Karolinska Institutet.
    Kneck, Åsa
    Karolinska Institutet.
    Nilsen, Per
    Linköpings universitet.
    Årestedt, Kristofer
    Linnéuniversitetet; Länssjukhuset i Kalmar.
    Ekstedt, Mirjam
    Karolinska institutet; Kungliga Tekniska högskolan (KTH); Länssjukhuset i Kalmar.
    The supporting patient activation in transition to home (sPATH) intervention: a study protocol of a randomised controlled trial using motivational interviewing to decrease re-hospitalisation for patients with COPD or heart failure2017Ingår i: BMJ Open, E-ISSN 2044-6055, Vol. 7, nr 7, s. 1-8, artikel-id e014178Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction Deficient hospital discharging and patients struggling to handle postdischarge self-management have been identified as potential causes of re-hospitalisation rates. Despite an increased interest in interventions aiming to reduce re-hospitalisation rates, there is yet no best evidence on how to support patients in being active participants in their self-management postdischarge. The aim of this paper is to describe the study protocol for an upcoming randomised controlled trial (RCT) of the Supporting Patient in Activation to Home (sPATH) intervention.

    Methods/analysis The described study is a randomised, controlled, analysis-blinded, two-site trial, with primary outcome re-hospitalisation within 90 days. In total, 290 participants aged 18 years or older with chronic obstructive pulmonary disease or congestive heart failure who are admitted to hospital and who are living in an own home will be eligible for inclusion into an intervention (n=145) or control group (n=145). Patients who need an interpreter to communicate in Swedish, or who have a diagnosis of dementia or cognitive impairment, will be excluded from inclusion. The sPATH intervention, developed with a theoretical base in the self-determination theory, consists of five postdischarge motivational interviewing sessions (face to face or by phone). The intervention covers the self-management areas medication management, follow-up/care plan, symptoms/signs of worsening condition and relations/contacts with healthcare providers. This RCT will add to the literature on evidence to support patient activation in postdischarge self-management.

    Ethics and dissemination The study is approved by the Regional Research Ethics Committee (No. 2014/1498-31/2) in Stockholm, Sweden. The results of the study will be published in peer-reviewed journals and presented at international and national scientific conferences. 

    Trial registration number NCT02823795; Pre-results.

  • 10.
    Gaber, Sophie Nadia
    et al.
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap. Department of Women’s and Children’s Health, Healthcare Sciences and e-Health, Uppsala University, Uppsala, Sweden.
    Rydeman, Ing-Britt
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Mattsson, Elisabet
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap. Department of Women’s and Children’s Health, Healthcare Sciences and e-Health, Uppsala University, Uppsala, Sweden.
    Kneck, Åsa
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Asking about violence and abuse among patients experiencing homelessness: A focus group study with healthcare professionals2024Ingår i: BMC Health Services Research, E-ISSN 1472-6963, Vol. 24, artikel-id 531Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: People experiencing homelessness are at increased risk of violence and abuse, however, there is insufficient knowledge about rates of inquiry or readiness of healthcare professionals to address violence and abuse among this population. This study aimed to explore healthcare professionals' experiences and perceptions of asking about violence and abuse among patients experiencing homelessness.

    METHODS: This study used a qualitative, interpretive, and exploratory design. We performed focus group discussions with healthcare professionals (n = 22) working at an integrative healthcare unit for people experiencing homelessness. Data were analysed using reflexive thematic analysis, following Braun and Clarke's six-phase approach. Findings are reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.

    RESULTS: The overarching theme of the analysis is that addressing violence and abuse is at risk of "falling through the cracks". The theme is supported by three sub-themes: Hesitance to address violence and abuse, The complex dynamics of violence and abuse in homelessness, and Challenges in addressing violence and abuse amidst competing priorities and collaborative efforts. The normalisation of violence and abuse within the context of homelessness perpetuates a "cycle" where the severity and urgency of addressing violence and abuse are overlooked or minimised, hindering effective interventions. Moreover, healthcare professionals themselves may inadvertently contribute to this normalisation. The hesitance expressed by healthcare professionals in addressing the issue further reinforces the prevailing belief that violence and abuse are inherent aspects of homelessness. This normalisation within the healthcare system adds another layer of complexity to addressing these issues effectively.

    CONCLUSIONS: The findings underscore the need for targeted interventions and coordinated efforts that not only address the immediate physical needs of people experiencing homelessness but also challenge and reshape the normalised perceptions surrounding violence and abuse. By prioritising awareness, education, and supportive interventions, we can begin to "break the cycle" and provide a safer environment where violence and abuse are not accepted or overlooked.

  • 11.
    Gerhardt, Karin
    et al.
    Sveriges Lantbruksuniversitet.
    Chen, Deliang
    Göteborgs universitet.
    Skelton, Alasdair
    Stockholms universitet.
    Gärde, Johan
    Marie Cederschiöld högskola, Institutionen för socialvetenskap.
    Kneck, Åsa
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Nog nu, politiker – ta klimatkrisen på allvar: 1 944 svenska forskare och anställda i forskarvärlden: Vad är det ni inte förstår?2022Ingår i: Aftonbladet, ISSN 1103-9000, nr 2022-08-25Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
    Abstract [sv]

    DEBATT. Som forskare och medborgare är vi arga och förtvivlade över den senaste tidens utveckling. Vi ser hur en majoritet av våra politiska partier överger klimatpolitiken och i stället föreslår eller genomför politik som går stick i stäv med Parisavtalet och Sveriges klimat- och miljömål.

    Våra politiker måste ta krisen på allvar och leda omställningen till ett framtida samhälle inom planetens gränser. Forskningen visar att en sådan framtid är möjlig. Det skriver 1 944 forskare och anställda från 45 svenska lärosäten och forskningsinstitut.

  • 12.
    Kassman, Anders
    et al.
    Ersta Sköndal Bräcke högskola, Centrum för civilsamhällesforskning.
    Hvenmark, Johan
    Ersta Sköndal Bräcke högskola, Centrum för civilsamhällesforskning.
    Kneck, Åsa
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Barn- och ungdomsfotboll under Coronapandemin: De svenska erfarenheterna visar att folkhälsa är mer än smittskydd2021Ingår i: Socialmedicinsk Tidskrift, ISSN 0037-833X, nr 1, s. 100-111Artikel i tidskrift (Refereegranskat)
    Abstract [sv]

    Undersökningen är en fallstudie av hur föreningsfotbollen i Stockholm och de nationella förbunden hanterade Coronapandemin våren 2020. I Sverige poängterades det personliga ansvaret vilket medförde att föreningar och ideellt engagerade ledare gavs ett stort ansvar att tolka, hantera och kontrollera efterföljden av de rekommendationer och restriktioner som beslutades. Resultaten visar att det på alla nivåer fanns farhågor att även ett tillfälligt stopp av verksamheten kunde få långsiktiga negativa konsekvenser bland annat på grund av minskad fysisk aktivitet. En nyckelhändelse var att St Erikscupen kunde genomföras vilket under pandemin adderade den ovana rollen för de ideella ledarna att försöka hålla vissa hygienregler samt att se till så att det inte samlades mer än max 50 personer i samband med matcherna.

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  • 13.
    Kassman, Anders
    et al.
    Marie Cederschiöld högskola, Centrum för civilsamhällesforskning.
    Kneck, Åsa
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Doing childhood, doing gender, but not doing sports: Unorganized girls’ reflections on leisure time from a relational perspective2022Ingår i: Childhood, ISSN 0907-5682, E-ISSN 1461-7013, Vol. 29, nr 2, s. 172-186Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim is to analyze how girls from a multi-ethnic area, not doing sports, reason about their well-being during leisure time, and how they think about physical activities, social relations, and their near future. The results say that they mainly regard leisure time as a moment for rest. They have close relations in primary groups but weaker secondary relations. They reveal stereotypical opinions about gender divisions in sports. Physical activity is unwanted and tiresome, if not part of playing.

  • 14.
    Kassman, Anders
    et al.
    Ersta Sköndal Bräcke högskola, Centrum för civilsamhällesforskning.
    Kneck, Åsa
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Doing it together. The dynamics of volunteer work in football clubs for children, the Swedish case2022Ingår i: Soccer & Society, ISSN 1466-0970, E-ISSN 1743-9590, nr 6, s. 1-14Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Football is one of the most popular organized leisure activities, and sports clubs organize many volunteers. But participation is stratified, volunteering among parents is class based and especially immigrant girls participate less. The aim of this study is to explore volunteering for children's football as a social activity from a relational perspective. We analyse the dynamics in the clubs to understand how structures are shaped in interaction between individuals and organizations. The study has a mixed-methods approach with interviews among club employees and a survey to volunteers. Our analysis reveal that the dynamics of the recruitment process results in a homogenic group of volunteers from a more affluent area and that flexible working hours is a key mechanism in the stratification process. Even so the playing children seems to be a more heterogenic group and especially boys seem to be recruited from a wider community.

  • 15.
    Kassman, Anders
    et al.
    Ersta Sköndal Bräcke högskola, Centrum för civilsamhällesforskning.
    Kneck, Åsa
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Health-promotive and exclusionary mechanisms in civil society: A critical review of the empirical support for Putnam’s view of social capital2021Ingår i: Cogent Social Sciences, E-ISSN 2331-1886, Vol. 7, nr 1, artikel-id 1953768Artikel, forskningsöversikt (Refereegranskat)
    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.

  • 16.
    Kassman, Anders
    et al.
    Ersta Sköndal Bräcke högskola, Institutionen för socialvetenskap, Avdelningen för forskning om det civila samhället.
    Kneck, Åsa
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Hälsa och sociala relationer bland organiserade ungdomar: Integration och selektion2018Ingår i: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 95, nr 5, s. 517-527Artikel i tidskrift (Refereegranskat)
    Abstract [sv]

    Eftersom sociala relationer är viktiga för att främja hälsa så borde civilsamhällets organisationer, med sina många mötestillfällen, kunna bidra till folkhälsan. Denna systematiska litteraturöversikt av internationell forskning visar att ungdomsorganisationer kan bidra till förbättrad hälsa för deltagarna om de lyckas balansera stöd, kontroll och delaktighet på ett bra sätt. De vuxna ledarna har en viktig roll i denna process. Men risken är att selektionsprocesser gör att de med störst behov tenderar att hamna utanför, och att bättre hälsa bland deltagarna därför till stor del beror på att de med sämre hälsa väljer bort föreningsdeltagande. Föreningar är exklusiva i olika hög grad och det är därför missledande att ha generella förväntningar på att deltagande i civilsamhället ska kunna förbättra folkhälsan.

  • 17.
    Kassman, Anders
    et al.
    Ersta Sköndal Bräcke högskola, Centrum för civilsamhällesforskning.
    Kneck, Åsa
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Idrott och hälsa bland flickor: Uppfattningar och erfarenheter bland föräldrar från Somalia, Eritrea, Syrien och Sverige2021Rapport (Övrigt vetenskapligt)
    Abstract [sv]

    Den organiserande idrottsrörelsen har länge haft en central ställning i det svenska samhället och möjliggjort fysisk aktivitet för flera generationer. Samtidigt är flickor, och speciellt de med utomeuropisk bakgrund, underrepresenterade vad gäller deltagande i idrottsrörelsen. Mot bakgrund av detta syftar denna rapport att kasta ljus över flickors lägre deltagande. Rapporten bygger på fokusgruppsintervjuer med föräldrar födda i Syrien, Somalia, Eritrea och Sverige där föräldrars uppfattningar och erfarenheter kring idrott, barndom, hälsa och föreningsliv samt skillnader mellan pojkar och flickor behandlades.

  • 18.
    Kassman, Anders
    et al.
    Ersta Sköndal Bräcke högskola, Institutionen för socialvetenskap, Avdelningen för forskning om det civila samhället.
    Kneck, Åsa
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Ledarnas betydelse för hälsa och sociala relationer bland organiserade ungdomar2018Ingår i: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 95, nr 5, s. 517-527Artikel i tidskrift (Refereegranskat)
    Abstract [sv]

    Eftersom sociala relationer är viktiga för att främja hälsa så borde civilsamhällets organisationer, med sina många mötestillfällen, kunna bidra till folkhälsan. Denna systematiska litteraturöversikt av internationell forskning visar att ungdomsorganisationer kan bidra till förbättrad hälsa för deltagarna om de lyckas balansera stöd, kontroll och delaktighet på ett bra sätt. De vuxna ledarna har en viktig roll i denna process. Men risken är att selektionsprocesser gör att de med störst behov tenderar att hamna utanför, och att bättre hälsa bland deltagarna därför till stor del beror på att de med sämre hälsa väljer bort föreningsdeltagande. Föreningar är exklusiva i olika hög grad och det är därför missledande att ha generella förväntningar på att deltagande i civilsamhället ska kunna förbättra folkhälsan.

  • 19.
    Kassman, Anders
    et al.
    Marie Cederschiöld högskola, Institutionen för civilsamhälle och religion, Centrum för civilsamhällesforskning.
    Kneck, Åsa
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Blomqvist Mickelsson, Tony
    Södertörns högskola.
    Hur kan ledare inom idrottsrörelsen navigera delvis motsägelsefulla förväntningar från utövare, föräldrar, styrelsen och staten?2024Konferensbidrag (Övrigt vetenskapligt)
    Abstract [sv]

    Genom idrottsrörelsens verksamhet förväntas ett brett spektrum av mervärden, utöver enbart idrottslig utveckling och sportsliga framgångar. Främjandet av fysisk aktivitet, samhörighet, meningsfull fritidssysselsättning, social inkludering, integration, demokratisk fostran och brottförebyggande arbete bidrar till att motivera statlig och kommunal finansiering. I det implicita kontraktet mellan staten och idrottsrörelsen ingår även en aktiv strävan att vara öppen och tillgänglig för alla. Engagemanget för breddat deltagande utspelar sig i hög grad inom lokala medlemsbaserade föreningar, där ideella ledare står inför komplexa utmaningar. Ledaren har en nyckelroll, navigerar genom behov och förväntningar från utövare, föräldrar, styrelser och stat där egna förmågor och resurser blir avgörande. För att underlätta för den ideella lokala ledaren behövs olika former av stödstrukturer som behöver synliggöras tillsammans med ledarnas förutsättningar och bidrag till idrottsrörelsen.

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  • 20.
    Klang Söderkvist, Birgitta
    et al.
    Karolinska institutet.
    Kneck, Åsa
    Ersta Sköndal högskola, Institutionen för vårdvetenskap.
    Patientens lärande2013Ingår i: Att skapa pedagogiska möten i medicin och vård / [ed] Charlotte Silén; Klara Bolander Laksov, Lund: Studentlitteratur AB, 2013, 1 uppl, s. 237-268Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 21.
    Klarare, Anna
    et al.
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap. Department of Women’s and Children’s Health, Healthcare Sciences and e-Health, Uppsala University, Uppsala, Sweden.
    Ekström, Veronica
    Marie Cederschiöld högskola, Institutionen för socialvetenskap.
    Godskesen, Tove
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap. Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
    Westman, Jeanette
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Mattsson, Elisabet
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap. Department of Women’s and Children’s Health, Healthcare Sciences and e-Health, Uppsala University, Uppsala, Sweden.
    Kneck, Åsa
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Treatment of trauma-related conditions for people in homelessness: A scoping review2024Ingår i: Journal of social distress and the homeless, ISSN 1053-0789, E-ISSN 1573-658XArtikel, forskningsöversikt (Refereegranskat)
    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. 

  • 22.
    Klarare, Anna
    et al.
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap, Palliativt forskningscentrum, PFC.
    Kneck, Åsa
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    How the selection of research methods can give women in homelessness a voice and a choice: An attempt to promote an inclusive society with gender equality, health and well-being for all2022Konferensbidrag (Övrigt vetenskapligt)
  • 23.
    Klarare, Anna
    et al.
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap. Uppsala universitet.
    Rydeman, Ing-Britt
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Kneck, Åsa
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Bos Sparén, Elisabeth
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Winnberg, Elisabeth
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Bisholt, Birgitta
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap. Röda Korsets Högskola.
    Methods and strategies to promote academic literacies in health professions: A scoping review2022Ingår i: BMC Medical Education, E-ISSN 1472-6920, Vol. 22, nr 1, artikel-id 418Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background: Universities enroll students from diverse backgrounds every year, with 300 million students expected in higher education by 2025. However, with widening participation, increasing numbers of students enrolling in higher health education and future health professions will be underprepared to meet demands of academic literacies, i.e. ability to read, interpret and critically evaluate academic texts and communicating the understanding verbally or in writing. The aim of this scoping review was to describe and explore methods and strategies to promote development of academic literacies.

    Results: Thirty-one relevant studies were included and analyzed according to scoping review guidelines. The results showed four strategies: (1) integrating learning activities to develop academic literacies in the regular curriculum, (2) changing the course design with new methods for teaching and learning, (3) establish collaborations amongst academics and librarian faculty, and (4) adding courses or foundation year focusing on development of academic literacies. The results are discussed in light of the United Nations Agenda 2030 Sustainable Development, Goal 4, Quality Education, and widening participation.

    Conclusions: Aspects of widening participation and inclusion in higher education have been debated, and increasing numbers of students from diverse backgrounds are expected to enter health studies in higher education. We encourage integration of teaching and learning activities targeting parallel learning of course materials and development of academic literacies, beyond study skills. Embracing epistemic complexity and diversity as well as choosing strategic work with academic literacies may provide a starting point toward realizing sustainable development goals and widening participation.

  • 24.
    Klarare, Anna
    et al.
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap, Palliativt forskningscentrum, PFC. Department of Women’s and Children’s Health, Healthcare Sciences and e-Health, Uppsala University, Uppsala, Sweden.
    Vamstad, Johan
    Marie Cederschiöld högskola, Institutionen för civilsamhälle och religion, Centrum för civilsamhällesforskning.
    Mattsson, Elisabet
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap. Department of Women’s and Children’s Health, Healthcare Sciences and e-Health, Uppsala University, Uppsala, Sweden.
    Kneck, Åsa
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Salzmann-Erikson, Martin
    Faculty of Health and Occupational Studies, Department of Caring Sciences, University of Gävle, Gävle, Sweden.
    Social rights in relation to digitalization, mobile phone, and internet use – experiences of women in homelessness: A qualitative study2024Ingår i: Critical Public Health, ISSN 0958-1596, E-ISSN 1469-3682, Vol. 34, nr 1, s. 1-16Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Given the fact that women in homelessness face considerable health inequities, the question of how digitalization can be understood in relation to social rights and right to health surfaces. The objective of this qualitative interview study was to explore the use of mobile phones and internet for women experiencing homelessness. Women (n = 26) shared experiences of healthcare access by using a mobile phone or internet. Data were analyzed using NVivo software. The results are presented in two themes: Conditions and circumstances of having a mobile phone; and Structural and intrapersonal challenges affecting social rights. The results show that digitalization actively influenced everyday life for women experiencing homelessness. Whether women wanted it to or not, digitalization presents a line of demarcation for participation and inclusion or exclusion, in health- and social-care services.

  • 25.
    Kneck, Åsa
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Fungerande, behovsstyrd och resursstärkande samverkan: Avgörande för att den våldsutsatta kvinnan i hemlöshet ska kunna erbjudas traumavård2023Konferensbidrag (Refereegranskat)
    Abstract [sv]

    Det övergripande syftet för projektet är att öka möjligheten för våldsutsatta kvinnor i hemlöshet att kunna erbjudas traumavård vilket förutsätter att våldet identifieras och fungerande samverkan inom och mellan ett antal välfärdsinstitutioner. För kvinnor är våld både en orsak till, och en konsekvens av hemlöshet, där kvinnan sällan erbjuds traumavård och behandling pga. drogmissbruk, samsjuklighet och avsaknad av stabila levnadsförhållanden. Att kvinnan lämnas ensam att hantera sina trauman bidrar till psykisk och fysisk ohälsa, ökad droganvändning och begränsade möjligheter att ta sig ur hemlösheten. Fungerande samverkan mellan och inom socialtjänsten – samt med hälso-och sjukvården är avgörande för att kvinnas komplexa behov ska tillgodoses och för att våldet inte ska förbises eller normaliseras.

    Strukturella, organisatoriska och individuella hinder för samverkan utmanar en fungerande samordning där kvinnas möjlighet och förmåga att vara delaktig och beslutskompetent är begränsad. Krav på hälsosjukvård och socialtjänstpersonal att skapa förutsättningar för delaktig är omfattande men svåruppnåeliga. Kvinnor i hemlöshet har länge betraktats som passiva, beroendet av andras agerande, stöd och omsorg dära utonomi, värdighet eller integritet är hotad. Utan att förbise denna utsatthet behöver kvinnan även ses som aktiv, kompetenta och ansvarstagande med möjlighet att påverka sin situation. Planerat projekt har en explorativ och samskapande design där våldsutsatta kvinnor i hemlöshet och olika personalkategorier medverkar i forskningsprocessen. Data utgörs främst av kvalitativt material. Ingående studier belyser både professions- och brukar/patientperspektiv och rör identifiering av våldsutsatthet, samspel och handlingsutrymme vid samordnad individuell plan samt utveckling av intervention för ökad samverkan.

  • 26.
    Kneck, Åsa
    Ersta Sköndal högskola, Institutionen för vårdvetenskap.
    Learning to live with diabetes: as experiencing an expanding life world2011Ingår i: Diabetesvård : tidning för Svensk förening för sjuksköterskor i diabetesvård, ISSN 1652-697X, nr 2-3, s. 14-15Artikel i tidskrift (Övrigt vetenskapligt)
  • 27.
    Kneck, Åsa
    Karolinska institutet.
    Learning to live with diabetes: as experiencing an expanding life world2011Licentiatavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Introduction: Chronic illness, such as diabetes, results in a transition process involving a variety of changes in both bodily function and conditions for living, and requiring broad knowledge and understanding in order to meet new demands. The outcomes of a healthy transition are described as well-being and mastery, in contrast to vulnerability and dependency. Little is known about how time for experience contributes to the transition of living with a chronic illness. 

    Aim: The overall aim of the thesis was to illuminate the transition of living with diabetes during the first three years after diagnosis, in order to reach an understanding of how better to create more person-centred care.

    Design: The study has a life world phenomenological approach with a longitudinal, descriptive and interpretive design. Thirteen participants were interviewed within two months after diagnosis and again after three years. A selected sample approach was used. For study I a qualitative inductive content analysis was used and for study II a phenomenological-hermeneutic method.

    Findings: In study I four themes were found; ‘taken over by a new reality,’ ‘the body plays a role in life’, ‘different ways of learning’ and ‘the health care service as a necessary partner’ and in study II one overall theme; Experience for understanding the individual meaning of freedom and control in living with diabetes and two themes ´Solving the life-puzzle – a delicate balance to create the desired life´ and ´The need for being in control of your own health´.

    Discussion: For a healthy transition when living with diabetes, the ability to interact with others in order to share their experiences was crucial and contributed towards participants understanding themselves and their life world. In order to be able to interact, participants had to understand their body as a subject, interlaced with the self and the life, the lived body. Being able to listen to the body and interpret body cues and circumstantial information also contributed to a healthy transition. When the body with diabetes was objectified, a struggle ensued where incompatible needs were experienced and contradictory information created insecurity. The person then preferred not to interact with others but to be dependent on advice and information from the health care service.

    Conclusion: This study showed that duration of illness was not of importance for the understanding of living with diabetes. Three years after being diagnosed, living with diabetes meant an experience both of overall balance in one’s existence and of a daily struggle. Health care personnel are open to the unique experience of the person living with diabetes as well as to where the person is in the transition. Patient education in a group setting, with the goal of sharing experiences in a learning process, will be meaningful only if the person has the ability to interact with others.

  • 28.
    Kneck, Åsa
    Karolinska institutet, Institutionen för neurobiologi, vårdvetenskap och samhälle.
    Living with diabetes: a lifelong learning process2015Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Living with diabetes, as a lifelong illness, is interlaced with learning and to face continual changes. However, the role of time in this learning process is not yet well understood. The overall aim of the thesis was to gain a deepened understanding of learning to live with diabetes for those recently diagnosed and over a three year period. The thesis, involving four studies where qualitative inductive content analysis (I, III) and phenomenological hermeneutical interpretation (II, IV) were used, has a lifeworld approach and a qualitative and longitudinal design. Thirteen persons, recently diagnosed with diabetes (type I or II), were interviewed on three different occasions over a three year period. All interviews focused on the experience of living with diabetes and situations where diabetes had to be taken into account. The aim of study I was to reach an understanding of how learning to live with diabetes is experienced in the first 2 months after diagnosis. The findings revealed to be taken over by a new reality, with a body that played a role in life with the health care service as a necessary partner. The aim of study II was to illuminate the meaning of learning to live with diabetes three years after being diagnosed. The findings revealed learning as making decisions through use of different sources of information and as solving the life-puzzle – a delicate balance to create a desired life. The aim of study III was to identify patterns in learning when living with diabetes, from recently being diagnosed, and over a 3-year period. In the findings five patterns were identified illuminating different learning processes emerging over time. A longer time living with diabetes did not per se mean increased satisfaction in living well with illness or increased confidence in understanding one’s own needs. The aim of the IV study was to illuminate the meanings of trigger situations in learning to live with diabetes. The findings revealed trigger situations, such as being encumbered by vulnerability and temporality in unsustainable situations with an unpredictable body and a life involving new concerns for the future. The thesis conducted that learning was an informal and ongoing everyday process in life. Time living with diabetes meant both an increased mastery of a changed life situation, but also increased difficulties in achieving well-being and with a dependency on health care. Hence, health care interventions must adhere to the individual’s needs and not be based on duration of illness. Understanding the body and the role of health care, as well as what facilitates and hampers learning, changed with time. It is therefore important that health care personnel illuminate the individual understanding and experiences of those living with diabetes as this was found to be important for the learning process as well as for their sense of well-being.

  • 29.
    Kneck, Åsa
    Ersta Sköndal högskola, Institutionen för vårdvetenskap.
    Lärandet i livet med långvarig sjukdom2018Ingår i: Patientundervisning: ett samspel för lärande / [ed] Birgitta Klang Söderkvist; Åsa Kneck, Lund: Studentlitteratur AB, 2018, 4 uppl, s. 23-46Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 30.
    Kneck, Åsa
    Ersta Sköndal högskola, Institutionen för vårdvetenskap.
    Symposium Abstract #3: Learning to Live With Diabetes: A Changing Process Over Time2016Ingår i: Abstracts, Oral Presentations for Qualitative Methods Conference, May 2016: Symposium: Longitudinal Qualitative Analysis—How Can It Be Done?, 2016, s. 4-5Konferensbidrag (Refereegranskat)
    Abstract [en]

    How time influences the learning process for persons living with diabetes is not fully understood. In previous research, learning to live with a lifelong illness has been described either as a linear process or a fluctuating process and consensus seems to be far away. In this longitudinal descriptive qualitative study, the aim was to identify patterns of learning in relation to living with newly diagnosed diabetes. Thirteen participants, with Type I or Type II diabetes, were interviewed at three occasions during a 3 years period. A qualitative content analysis was used with a pattern-oriented analysis approach. The result shows that the participants moved through their learning in conceptually different ways. In total, five patterns of the learning process were identified: (1) finding the balance to gradually letting oneself live; (2) being active in searching for knowledge in order to gain control; (3) despite obstacles, having the strength to maintain what is important; (4) increasingly difficult to obtain acceptable blood glucose level and to live well with diabetes; and (5) adapting to minor changes in daily life. This study challenges the common notion in health care of learning as linear and related to time since diagnosis. In the present study, duration of illness was not important for the learning process. Instead, participants’ needs, beliefs, and values related to illness differed in the patterns and changed over time. This study was able to present individuals’ differences and thereby show the value of using a pattern-oriented analysis approach in longitudinal qualitative research.

  • 31.
    Kneck, Åsa
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Våld som en del av vardagen: Samskapande forskning för att ge möjlighet för patienter i hemlöshet att bejaka våldsutsatthet i vårdmötet2023Konferensbidrag (Övrigt vetenskapligt)
    Abstract [sv]

    Personer som lever i hemlöshet är sjukare, både fysiskt och psykiskt och har kortare livslängd än genomsnittsbefolkningen. Problem med ohälsa till följd av missbruk, trauma, våldsutsatthet i kombination med avsaknad av fast bostad gör personer i hemlöshet särskilt utsatta. Samverkan mellan olika aktörer är avgörande för att säkerställa adekvata åtgärder för den som blivit våldsutsatt. Våld är vanligt förekommande som både orsak till och konsekvens av hemlöshet men ges sällan prioritet i vårdmötet, vare sig av patient eller vårdgivare. Traumabehandling försvåras ofta av, eller är inte alls tillgänglig, för den som har en missbruksproblematik och/eller saknar bostad. Samtidigt är missbruk eller ”självmedicinering” vanligt hos den som blivit utsatt för våld och befinner sig i hemlöshet.

    I ett samskapande forskningsprojekt mellan Capio Vård för hemlösa öppenvård -Pelarbacken och Marie Cederschiöld högskola har ett flerårigt projekt för att utveckla vården för personer i hemlöshet som blivit våldsutsatta genomförts. Interventioner för att identifiera, slussa/samordna samt erbjuda initiala samtal och behandlingsåtgärder för personer i hemlöshet som blivit våldsutsatta har utvecklats och implementerats. Målsättningen har varit att identifiera patienter som blivit våldsutsatta genom att systematiskt fråga alla patienter som besöker Pelarbacken samt ett erbjuda vårdinsatser efter behov. Visuellt material har utvecklats för att främja dialog och reflektion kring våld vid hemlöshet, som ofta är normaliserat hos både patienter och personal. I forskningsprojektet har upprepade datainsamling med personalenkäter och fokusgruppsintervjuer genomförts för att studera utveckling och implementering av interventionerna. Preliminära resultat visar på svårigheter för både patienter och personal att prioritera våldet i vårdmötet. Slutsatser från forskningsprojektet är behov av bredare samverkan för att kunna bejaka våldsutsatthet i vårdmötet där patientens komplexa behov av både interventioner från hälso-sjukvården samt socialtjänsten måste utvecklas.

  • 32.
    Kneck, Åsa
    et al.
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Ahlstedt, Annika
    Capio Vård för hemlösa Pelarbacken, Stockholm.
    Essemyr, Klara
    Capio Vård för hemlösa Pelarbacken, Stockholm.
    Våld som en del av vardagen i livet som hemlös: Hur får vi patienter att vilja prata om våldsutsatthet?2021Konferensbidrag (Övrigt vetenskapligt)
    Abstract [sv]

    På Capio Vård för hemlösa öppenvård Pelarbacken och heldygnsvård pågår ett projekt med syfte att utveckla en vårdmodell för personer i hemlöshet som blivit våldsutsatta. Fokus är att identifiera, slussa/samordna samt erbjuda initiala samtal och behandlingsåtgärder. Projektet följs av en forskargrupp på Ersta Sköndal Bräcke högskola.

    Preliminära resultat från det initiala skedet att identifiera patienter genom att systematiskt fråga alla patienter som besöker Pelarbacken om våldsutsatthet visar på flera utmaningar vilka de flesta även beskrivits för andra vårdkontexter. Här kan nämnas en osäkerhet hos personalen kring hur man frågar och ramar in samtal om våld samt svårigheter med integreringen av nya rutiner i verksamheten. Det framkom också att våldet var så normaliserat att patienter inte själva uppfattar att de blivit våldsutsatta trots att de sökte för skador till följd av våld. Vidare har antalet patienter som önskat kuratorkontakt varit betydligt längre än förväntat. Skriftlig information till patienter i form av broschyrer samt att vårdpersonal informerat i väntrum har kompletterats med visuella metoder i form av bilder i syftet att stimulera reflektion och dialog kring våld.  Processen att identifiera val av bilder har genomförts i samverkan mellan en kvinna på skyddat boende, vårdpersonal på Pelarbacken och forskare.

    I processen att erbjuda initiala samtal och behandlingsåtgärder har ett underlag för samtal utarbetats där anpassningar har gjorts för att tillmötesgå behov och förutsättningar hos målgruppen.

    Konferenspresentationen kommer innehålla exempel på bildmaterial och underlag för samtal.

  • 33.
    Kneck, Åsa
    et al.
    Ersta Sköndal högskola, Institutionen för vårdvetenskap.
    Audulv, Åsa
    Mittuniversitetet.
    A pattern-oriented approach: Practical advice about longitudinal qualitative analysis procedures2016Ingår i: Programme - Abstracts: Nordic conference in nursing research: methods and networks for the future: 2016, 15-17 June, Stockholm: Programme: second nordic conference in nursing research, 2016, s. 34-34Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background: The number of published longitudinal qualitative studies has increased over the last couple of years. However, there is no consensus in how longitudinal analysis should be conducted or presented. Overall, little literature about the procedures of doing qualitative longitudinal analysis has been published. The aim of this presentation is to describe a procedure for conducting longitudinal qualitative analysis (e.g., a pattern oriented approach).

    Method: Independently of each other the two authors have developed a similar approach to analyze interview data over time. The two individual analyses have been compared and common features identified.

    Results: A pattern-oriented analysis focuses upon how individuals (or phenomena) move through a process/time in identifiable patterns. When other longitudinal analysis approaches might emphasize a main process, a pattern-oriented approach accounts for the individual variance in the context of time and change. The key features of the analysis procedure include; ‘identifying the process’, ‘summarized description’ and ‘using matrixes’.

    Conclusion: A pattern-oriented analysis is a fruitful way of viewing ways of changing over time and thus understanding complex life processes.

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  • 34.
    Kneck, Åsa
    et al.
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Audulv, Åsa
    Mittuniversitetet.
    Analyzing variations in changes over time: development of the Pattern-Oriented Longitudinal Analysis approach.2019Ingår i: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 26, nr 3, artikel-id e12288Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Longitudinal qualitative research in nursing is rare but becoming more common. Data collection and analysis over time provide some intriguing possibilities to better understand processes, development, and change in illness experience, healthcare organizations, and self-management. This paper aims to present a process for analyzing qualitative longitudinal data material, namely the Pattern-Oriented Longitudinal Analysis approach (POLA). We developed this approach after synthesizing experiences from two longitudinal qualitative projects and comparing our procedures and reflections with the relevant literature. Using the POLA approach, researchers can describe complexity and variation in changes over time. During the analysis process, emphasis is put on visualizing and identifying change at both an individual and a group level. Ontological and epistemological assumptions for the approach are also described. The benefit of this approach is the possibility to describe complexity and diversity in processes over time, which is important for the development of nursing knowledge. The analysis approach can be further used and developed by researchers seeking to understand variance or contextual features in processes and changes over time.

  • 35.
    Kneck, Åsa
    et al.
    Ersta Sköndal högskola, Institutionen för vårdvetenskap. Karolinska institutet.
    Eriksson, Lars E.
    Karolinska institutet; Karolinska universitetsjukhuset; School of Health Sciences, City University, London, United Kingdom.
    Lundman, Berit
    Umeå universitet.
    Fagerberg, Ingegerd
    Ersta Sköndal högskola, Institutionen för vårdvetenskap. Karolinska institutet.
    Encumbered by vulnerability and temporality: the meanings of trigger situations when learning to live with diabetes2016Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, nr 19-20, s. 2874-2883Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS AND OBJECTIVES: The aim of the study was to illuminate the meanings of trigger situations experienced in everyday life when learning to live with diabetes.

    BACKGROUND: Adults become active learners when faced with situations they do not know how to manage, triggering a need to understand something in a different way than before. Knowing more about experiential learning for persons living with diabetes is important for understanding how learning can be supported by health care.

    DESIGN: A life-world approach with a phenomenological hermeneutical method, inspired by the philosophy of Paul Ricoeur.

    METHODS: This method was used for interpreting transcriptions of interviews and consists of three stages: naïve understanding, structural analysis and a comprehensive understanding. Participants (n = 13), with either type I or type II diabetes, were interviewed on three different occasions over a three-year period after being diagnosed with diabetes.

    RESULTS: When learning to live with diabetes, the meanings of trigger situations were described as 'the unpredictable body heightens insecurity with awareness of one's own dependability', 'losing control in unsustainable situations' and 'encumbered by vulnerability and temporality in earlier familiar situations'.

    CONCLUSION:The meanings of trigger situations were to lose the smooth, unreflected way of managing an everyday life situation, interlaced with feelings of lost control of how to live with new insights of being vulnerable. Trigger situations meant an opportunity for learning, as well as being demanding, unplanned and with limited freedom of choice. Trigger situations presented life and body as unpredictable.

    RELEVANCE TO CLINICAL PRACTICE: If healthcare professionals can identify the worries and questions raised in trigger situations, knowledge gaps can be identified and reflected on to stimulate learning.

  • 36.
    Kneck, Åsa
    et al.
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Ewertzon, Mats
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap. Swedish Family Care Competence Centre, Kalmar.
    Leksell, Janeth
    Department of Medical Sciences, Uppsala University.
    Årestedt, Kristofer
    Faculty of Health and Life Sciences, Linnaeus University, Kalmar; The Research Section, Region Kalmar County, Kalmar.
    Amsberg, Susanne
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    I have never been invited: A cross-sectional explorative study of family members' experiences of encounters with healthcare professionals in diabetes care2024Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 38, nr 1, s. 82-91Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To explore the experiences of family members of adult persons with type 1 diabetes concerning both the approach of healthcare professionals and feelings of alienation in encounters with professional diabetes care.

    METHODS: A cross-sectional explorative quantitative and qualitative design. The Family Involvement and Alienation Questionnaire-Revised (FIAQ-R), including an open-ended question, was answered by 37 family members of adult persons with type 1 diabetes. Analyses included descriptive statistics and qualitative analysis. The study has received ethical approval.

    RESULTS: Family members rated the approach of the healthcare professionals as being somewhat positive and considered that the approach towards them is important. They only felt partially alienated from the professional care. Qualitative data revealed that the family members often lacked direct access to the professional care and that their involvement was dependent on their relationship with the person with diabetes. Findings highlighted that the family members' wish to be involved in the care was sometimes unanswered.

    CONCLUSION: Based on the findings, it is reasonable to stress the importance of considering family members' perspectives and involving them in diabetes care to improve overall patient support.

  • 37.
    Kneck, Åsa
    et al.
    Ersta Sköndal högskola, Institutionen för vårdvetenskap. Karolinska institutet, Institutionen för neurobiologi, vårdvetenskap och samhälle.
    Fagerberg, Ingegerd
    Ersta Sköndal högskola, Institutionen för vårdvetenskap. Karolinska institutet, Institutionen för neurobiologi, vårdvetenskap och samhälle.
    Eriksson, Lars E
    Karolinska Institutet.
    Lundman, Berit
    Umeå universitet.
    Living with diabetes: Development of learning patterns over a 3-year period2014Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, artikel-id 24375Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Learning involves acquiring new knowledge and skills, and changing our ways of thinking, acting, and feeling. Learning in relation to living with diabetes is a lifelong process where there is limited knowledge of how it is experienced and established over time. It was considered important to explore how learning was developed over time for persons living with diabetes.

    Aim: The aim of the study was to identify patterns in learning when living with diabetes, from recently being diagnosed, and over a 3-year period.

    Materials and methods: A longitudinal qualitative descriptive design was used. Thirteen participants, with both type I and type II diabetes, were interviewed at three different occasions during a 3-year period. Qualitative content analysis was used in different steps in order to distinguish patterns.

    Findings: Five main patterns of learning were identified. Two of the patterns (I and II) were characterized by gradually becoming comfortable living with diabetes, whereas for one pattern (IV) living with diabetes became gradually more difficult. For pattern V living with diabetes was making only a limited impact on life, whereas for Pattern III there was a constant management of obstacles related to illness. The different patterns in the present study showed common and different ways of learning and using different learning strategies at different timespans.

    Conclusion: The present study showed that duration of illness is not of importance for how far a person has come in his own learning process. A person-centered care is needed to meet the different and changing needs of persons living with diabetes in relation to learning to live with a lifelong illness.

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  • 38.
    Kneck, Åsa
    et al.
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Flink, Maria
    Karolinska institutet.
    Frykholm, Oscar
    Karolinska institutet.
    Kirsebom, Marie
    Linnéuniversitetet.
    Ekstedt, Mirjam
    Karolinska institutet; Linnéuniversitetet.
    The Information Flow in a Healthcare Organisation with Integrated Units.2019Ingår i: International journal of integrated care, ISSN 1568-4156, Vol. 19, nr 3, s. 1-10, artikel-id 20Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Integrated care is believed to provide support to patients with multiple long-term and complex conditions. Transparency in information delivery is key for shared decision-making, and co-production of care. This study aimed to explore information pathways within an integrated healthcare and social care organisation and describe how information continuity was delivered for an older patient with complex care needs.

    Methods: An explorative single-case study conducted in a Swedish healthcare organization where municipality and the county council have integrated their services. One focus group discussion and six individual interviews were conducted.

    Results: Information flow to partners in care was obstructed, with compensatory double documentation, complementary information channels, and information loss. A heavy burden was on the patient and relatives to keep track of and communicate information between different caregivers. Patients were expected to be active partners in their own care, but were largely excluded from the information flow.

    Discussion: Even integration of care organisations does not imply that integrated care is delivered at the sharp end of practice. An integrated electronic health record is needed to improve accessibility of care information from within all the organisations, facilitating handovers between professionals and levels of care, and involving patients in the information flow.

  • 39.
    Kneck, Åsa
    et al.
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Kassman, Anders
    Marie Cederschiöld högskola, Institutionen för civilsamhälle och religion, Centrum för civilsamhällesforskning.
    Fysisk aktivitet, idrott och hälsa bland flickor: Forskning med föräldrar från Somalia, Eritrea, Syrien och Sverige2022Ingår i: Skolhälsan, ISSN 0284-284X, nr 4, s. 30-31Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
    Abstract [sv]

    Svenska flickor med utländsk bakgrund är mindre fysiskt aktiva än andra barn. Svensk idrottsrörelse har en särskild nordisk prägel som kräver mycket av föräldrarna.

  • 40.
    Kneck, Åsa
    et al.
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Kassman, Anders
    Marie Cederschiöld högskola, Institutionen för civilsamhälle och religion, Centrum för civilsamhällesforskning.
    Idrottsrörelsen är inte anpassad för alla: Flickors erfarenheter om fysiska aktiviteter i och utanför den organiserade idrotten2023Ingår i: Socialmedicinsk Tidskrift, ISSN 0037-833X, nr 4, s. 612-620Artikel i tidskrift (Refereegranskat)
    Abstract [sv]

    Syftet är att ge en inblick i hur flickor som inte deltar i organiserad idrott resonerar om fysisk aktivitet. Studien designades med fokusgrupper bland 18 flickor i åldrarna 9-12 år, 8 av dem följdes också upp tre år senare. I intervjuerna användes fotografier tagna av flickorna själva för att stimulera till erfarenhetsutbyte. Resultaten ger inblick i hur olika strukturella skillnader upplevs, hanteras och påverkar flickornas fysiska aktivitet. Flickorna är väl medvetna om samhällets förväntningar, men bland de som inte började tidigt med idrott blir det svårare ju äldre de blir. Det saknas fungerande utlopp för fysisk aktivitet efter barnaårens lekande. Varken skolans idrott, det egna promenerandet med kompisar eller olika mer tillfälliga aktiviteter med familjen räcker för att nå de högt satta målen för fysisk aktivitet.

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  • 41.
    Kneck, Åsa
    et al.
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Kassman, Anders
    Marie Cederschiöld högskola, Institutionen för civilsamhälle och religion, Centrum för civilsamhällesforskning.
    Organiserad idrott: viktig källa till fysisk aktivitet för många barn2022Ingår i: Diabetesvård : tidning för Svensk förening för sjuksköterskor i diabetesvård, ISSN 1652-697X, s. 20-20Artikel i tidskrift (Övrigt vetenskapligt)
  • 42.
    Kneck, Åsa
    et al.
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Kassman, Anders
    Marie Cederschiöld högskola, Institutionen för civilsamhälle och religion, Centrum för civilsamhällesforskning.
    Tankar från flickor kring fysisk aktivitet, hälsa och fritid: Samskapandeforskning med flickor som inte deltar i idrottsrörelsen2023Konferensbidrag (Övrigt vetenskapligt)
    Abstract [sv]

    Även om fysisk aktivitet är viktigt för alla barns hälsa så är flickor mindre fysiskt aktiva än pojkar och minst fysiskt aktiva är flickor med utländsk bakgrund. Fysisk aktivitet har kommit att bli något exklusivt med krav på medlemskap, transportmöjligheter, sker i organiserad form, på givna platser och tider.

    Vi har valt att lyssna och ge en röst till flickor som sällan hörs i diskussioner kring barn och fysisk aktivitet – flickor som inte deltar i idrottsrörelsen.

    I en photo-voice studie har åtta flickor i åldern 12-15 år träffats åtta gånger över en period om sju månader. Flickorna har tagit foton, analyserat dessa gemensamt och kollektivt bestämt nya teman att fördjupa vid kommande träffar. Fokusområden har varit fysisk aktivitet, fritid och hälsa. Som en del av metoden ingår att kommunicera med omgivande samhälle, vilket gjordes genom en publik fotoutställning där flickorna, förutom att visa sina foton med citat även hade möjlighet att ställa frågor till beslutsfattare inom politiken, skolan och civilsamhället. Utställningen gavs uppmärksamhet i både radio och tidningar.

    Resultat från studien var flickornas tvekan till rimligheten att nå Världshälsoorganisationens (WHO) mål om en timmes fysisk aktivitet per dag. Generellt uppfattades pojkar som mer fysiskt aktiva än flickor, på fritiden, på raster och i skolidrotten. Flickorna ansåg därför att utökad tid för skolämnet idrott och hälsa främst skulle gagna de som redan var idrottsaktiva. De själva kände sig mest i vägen för de mer tävlingsinrikade eleverna, ofta pojkar. Ett annat hinder för att ökad skolidrott skulle möjliggöra för mer fysisk aktivitet var flickornas motstånd till att riskera att bli svettig under skoltid vilket ansågs jobbigt främst på grund av motståndet mot att duscha i skolan.

    Helst önskade flickorna att vara fysiskt aktiva med sina familjer och att då få spendera tid tillsammans med dem. Samtidigt konstaterades att detta främst kunde ske vid vissa enstaka tillfällen och inte med den regelbundenhet som skulle krävas för att nå WHO:s mål om fysisk aktivitet. En slutsats från studien är att när fysisk aktivitet likställs med idrottsdeltagande så försvårar det för grupper som av olika skäl inte vill, kan eller får delta i den organiserad idrott att nå den mängd fysiska aktivitet som är viktig som en del av hälsofrämjande vanor. Detta får konsekvenser för möjligheten till jämlik hälsa då vi generellt har kommit att bli allt mer stillasittande vilket möjliggöras av en digital livsstil. Fysisk aktivitet blir således ett aktivt val, något som måste prioriteras i konkurrens med andra intressen. 

  • 43.
    Kneck, Åsa
    et al.
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Kassman, Anders
    Marie Cederschiöld högskola, Institutionen för civilsamhälle och religion, Centrum för civilsamhällesforskning.
    Uppfattningar om fysisk aktivitet, idrott, fritid och hälsa: Forskning med flickor som inte deltar i idrottsrörelsen2022Ingår i: Vårdmagasinet Hälsa : medlemstidning för distriktssköterskor, ISSN 2003-1165, nr 4Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
    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.

  • 44.
    Kneck, Åsa
    et al.
    Ersta Sköndal högskola, Institutionen för vårdvetenskap.
    Klang, Birgitta
    Karolinska Institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal högskola, Institutionen för vårdvetenskap.
    Learning to live with diabetes: integrating an illness or objectifying a disease2012Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 68, nr 11, s. 2486-2495Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: This paper is a report of a study of illuminating the meaning of ‘learning to live with diabetes’ 3 years after being diagnosed.

    Background: A changed situation, for example, in relation to living with diabetes, raises a need to understand. How time for experience contributes to this learning process for people living with diabetes is not yet well understood. It would therefore seem valuable to ask people, who have had diabetes over a similar length of time, to narrate their experience in relation to daily life situations in order to understand better how learning is established.

    Design: The study has a qualitative design.

    Methods: A life world approach was used, with interviews being conducted with 13 people who had been diagnosed with diabetes 3 years earlier. Data were collected in 2007, and analyses were conducted using a phenomenological-hermeneutic method.

    Findings: How a person experiences the physical body was found to be crucial in the learning process. If the body with its signals is understood it can be a tool for experiencing and understanding the world and oneself. Feeling insecure about one’s own needs, and not trusting or understanding bodily signs, made participants dependent on others to make decisions for them.

    Conclusion: This study showed that duration of illness was ‘not’ of importance for the understanding of living with diabetes. Living with diabetes 3 years after being diagnosed meant to experience both an overall balance in one’s existence and a daily struggle.

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  • 45.
    Kneck, Åsa
    et al.
    Ersta Sköndal högskola, Institutionen för vårdvetenskap.
    Klang, Birgitta
    Karolinska institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal högskola, Institutionen för vårdvetenskap.
    Learning to live with illness: experiences of persons with recent diagnoses of diabetes mellitus2011Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, nr 3, s. 558-566Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The process of learning to live with an illness is complex. By better understanding the learning process for persons with diabetes in the early stage of the illness, the role of the health care can be shown.

    Aim: To reach an understanding of how learning to live with diabetes is experienced in the first 2 months after diagnosis.

    Method: A qualitative descriptive design was used, and interviews were conducted. Thirteen participants with a recent diagnosis of diabetes were included and asked to narrate about their experience of living with diabetes. Qualitative inductive content analysis was used.

    Findings: Four themes emerged: ‘taken over by a new reality’, ‘the body plays a role in life’, ‘different ways of learning’ and ‘the healthcare service as a necessary partner’.

    Conclusion: People with short-term experience of the illness gained knowledge through personal resources such as their own experience and self-reflection. The learning process includes an inner dialogue between the self, the body and the life. Participants were concerned with grasping a new reality and understanding a different self and body where lifestyle changes and uncertainty were present. When health care was accessible and sensitive to their needs, those with short-term experience of diabetes chose the staff as key players in the early stages of their life with diabetes.

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  • 46.
    Kneck, Åsa
    et al.
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Klang Söderkvist, BirgittaKarolinska institutet.
    Patientundervisning: ett samspel för lärande2018Samlingsverk (redaktörskap) (Övrigt vetenskapligt)
  • 47.
    Kneck, Åsa
    et al.
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Klarare, Anna
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap. Uppsala universitet.
    Mattsson, Elisabet
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap. Uppsala universitet.
    Salzmann‐Erikson, Martin
    Högskolan i Gävle.
    Reflections on health among women in homelessness: A qualitative study2022Ingår i: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 29, nr 5, s. 709-720Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Mental health issues are common among women in homelessness, alongside undertreated chronic physical conditions leading to serious and unnecessary complications. Even though homelessness and risks of impaired health have been researched, broader perspectives of health are absent.

    Aim: To describe reflections on health among women with experiences of homelessness.

    Method: We conducted thirteen interviews with women in homelessness using researcher-driven photo elicitation. Together with an advisory board of women with lived experience of homelessness, researchers were guided by the DEPICT model for collaborative data analysis and performed a thematic analysis.

    Findings: Women with experiences of homelessness emphasized three main resources for achieving health and well-being: feelings of having a home, being involved in authentic relationships and experiences of preserved dignity.

    Implication for practice: Healthcare needs to integrate the perceived resources for health and well-being when caring for women in homelessness. It is imperative since women will return to the healthcare setting only if they feel safe and secure, and only if dignity is preserved or restored. The results promote utilization of an integrative nursing approach; understanding that the health of women in homelessness is inseparable from their environment and social determinants for health, such as housing and social integration.

  • 48.
    Kneck, Åsa
    et al.
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Mattsson, Elisabet
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap. Uppsala universitet.
    Salzmann-Erikson, Martin
    Högskolan i Gävle.
    Klarare, Anna
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap. Uppsala universitet.
    “Stripped of dignity” - Women in homelessness and their perspectives of healthcare services: A qualitative study2021Ingår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 120, artikel-id 103974Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: A much more substantial European evidence base on the accessibility of healthcare services among women experiencing homelessness across healthcare systems in Europe is warranted.

    Objective: To give voice to women with experiences of homelessness, and to explore their perspectives of healthcare services in an EU country with universal healthcare.

    Design: The study is part of a research program striving to promote equal healthcare through co-production with women in homelessness. An advisory board of women with lived experience of homelessness was established and a qualitative, interpretive and exploratory design was employed.

    Participants: 26 women with experience of homelessness were interviewed. Their median age was 46 years (range 42) and 70% were roofless/houseless.

    Methods: Data were analyzed with content analysis. Co-production and joint analyses were conducted by researchers and three women with experience of homelessness, using the DEPICT model for collaborative analysis.

    Results: The analysis resulted in one overall theme: Visiting healthcare from the outskirts of society, comprising three sub-themes: Demand for a life in order - Exclusion in action; Unwell, unsafe and a woman - Multifaceted needs challenge healthcare; and Abuse versus humanity – power of healthcare encounters to raise or reduce. Women's experiences of care encounters were disparate, with prevalent control, mistrust and stigma, yet healthcare professionals that demonstrated respect for the woman's human dignity was described both as life-altering and lifesaving.

    Conclusions: Women in homelessness live on the outskirts of society and have multiple experiences of exclusion and loss of dignity within healthcare services. The multifaceted care needs challenge healthcare, leading to women feeling alienated, invisible, disconnected and worthless. We urge registered nurses to take actions for inclusion health, i.e. focusing health efforts of people experiencing extreme health inequities. We can lead the way by speaking up and confronting discriminating behaviors, protecting and restoring human dignity in caring relationships, and framing healthcare services for all citizens.

  • 49.
    Mattsson, Elisabet
    et al.
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap. Uppsala universitet.
    Lindblad, Marléne
    Röda Korsets Högskola.
    Kneck, Åsa
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap.
    Salzmann-Eriksson, Martin
    Högskolan i Gävle.
    Klarare, Anna
    Marie Cederschiöld högskola, Institutionen för vårdvetenskap. Uppsala universitet.
    Voices of women in homelessness during the outbreak of the COVID-19 pandemic: A co-created qualitative study2023Ingår i: BMC Women's Health, E-ISSN 1472-6874, Vol. 23, nr 11Artikel i tidskrift (Refereegranskat)
    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.

  • 50.
    Momeni, Pardis
    et al.
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Årestedt, Kristofer
    Linnéuniversitetet.
    Alvariza, Anette
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap. Dalens sjukhus, Stockholm.
    Winnberg, Elisabeth
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Goliath, Ida
    Stiftelsen Stockholms läns Äldrecentrum.
    Kneck, Åsa
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap.
    Leksell, Janeth
    Uppsala universitet.
    Ewertzon, Mats
    Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap. Nationellt kompetenscentrum anhöriga, Kalmar.
    A survey study of family members' encounters with healthcare services within the care of older people, psychiatric care, palliative care and diabetes care2022Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 36, nr 4Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to describe and compare family members' experiences of approach in encounters with healthcare professionals and possible feelings of alienation in the professional care within four care contexts: the care of older people, psychiatric care, palliative care and diabetes care. The design was an explorative cross-sectional survey study. Data were collected in Sweden using the Family Involvement and Alienation Questionnaire-Revised (FIAQ-R). It measures family members' experiences of the healthcare professionals' approach and the family members' feeling of alienation from the provision of professional care. A total of 1047 questionnaires were distributed to family members using convenient sampling method, of which 294 were included. Data were analysed using rank-based, non-parametric statistical methods. The results indicated that most respondents experienced a positive actual approach from the healthcare professionals. Many participants rated the importance of approach at a higher level than their actual experience. Participants in the context of diabetes care reported a more negative actual approach from the healthcare professionals than did participants in the other contexts and considered the healthcare professionals' approach towards them as being less important. The results for the entire group indicated that the participants felt a low level of alienation from the professional care. Participants in the context of the care of older people reported significantly lower level of feeling of being alienated than did participants in the contexts of psychiatric care and diabetes care. The differences between participants in diabetes care and other care contexts can possibly be explained by a more fully implemented self-care approach among the patients in diabetes care than in the other care contexts. Even though the results are quite positive, it is still important that nurses consider a family-centred approach to better adapt to the needs of both the family members and the patients.

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