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  • 1.
    Ahlborg, Mikael
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Morgan, Antony
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Glasgow Caledonian University in London, London, United Kingdom.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Into the realm of social capital for adolescents: A latent profile analysis2019In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 2, article id e0212564Article in journal (Refereed)
    Abstract [en]

    Background

    Recent reports of increasing prevalence of frequent health complaints and mental health problems among adolescents call for directing more attention on determinants of adolescent health. The relationship between health and social capital has gained increased attention since the early 2000’s and research at review level confirms the importance of social capital for health outcomes, despite methodological heterogeneity. The aim of this study was to identify distinct profiles of family, school and peer social capital in a nationally representative sample of adolescents and to explore health outcomes in those profiles.

    Method

    Cross-sectional data from the Swedish Health Behaviour of School-aged Children 2013/14 was used for this study. The analytical sample consisted of 7,804 adolescents aged 11-, 13- and 15-years. Items representing sense of belonging and emotional support were assessed in three contexts; family, school and among peers. Latent profile analyses (LPA) were run to determine social capital profiles. Health outcomes included frequent health complaints and life satisfaction, while socioeconomic status and genders were included as predictors.

    Results

    The results show that five distinct profiles best represent the data for 11- and 15-year olds, while a four-profile model was optimal for 13-year olds. Some profiles were recurrent between age groups but unique profiles were also found. Health outcomes were significantly different between profiles depending on levels of social capital in the different contexts.

    Conclusions

    This study provides novel insight into how social capital co-occurs among adolescents within the contexts of family, school and peers and how this translates into differences in health outcomes. The national representativeness of the sample increases the implications of the results and contributes to meaningful insights that help explain the interactions of social capital in multiple contexts, complementing what is previously known about the relationship with adolescent health. © 2019 Ahlborg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

  • 2.
    Ahlborg, Mikael
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Morgan, Antony
    Glasgow Caledonian University, Glasgow, United Kingdom.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Socioeconomic inequalities in health among Swedish adolescents - adding the subjective perspective2017In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 17, article id 838Article in journal (Refereed)
    Abstract [en]

    Background

    Socioeconomic inequalities in adolescent health predict future inequalities in adult health. Subjective measures of socioeconomic status (SES) may contribute with an increased understanding of these inequalities. The aim of this study was to investigate socioeconomic health inequalities using both a subjective and an objective measure of SES among Swedish adolescents.

    Method

    Cross-sectional HBSC-data from 2002 to 2014 was used with a total sample of 23,088 adolescents aged 11–15 years. Three measures of self-rated health (dependent variables) were assessed: multiple health complaints, life satisfaction and health perception. SES was measured objectively by the Family Affluence Scale (FAS) and subjectively by “perceived family wealth” (independent variables). The trend for health inequalities was investigated descriptively with independent t-tests and the relationship between independent and dependent variables was investigated with multiple logistic regression analysis. Gender, age and survey year was considered as possible confounders.

    Results

    Subjective SES was more strongly related to health outcomes than the objective measure (FAS). Also, the relation between FAS and health was weakened and even reversed (for multiple health complaints) when subjective SES was tested simultaneously in regression models (FAS OR: 1.03, CI: 1.00;1.06 and subjective SES OR: 0.66, CI: 0.63;0.68).

    Conclusions

    The level of socioeconomic inequalities in adolescent health varied depending on which measure that was used to define SES. When focusing on adolescents, the subjective appraisals of SES is important to consider because they seem to provide a stronger tool for identifying inequalities in health for this group. This finding is important for policy makers to consider given the persistence of health inequalities in Sweden and other high-income countries. ©  The Author(s). 2017

  • 3.
    Arvidsson, Susann
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Gilljam, Britt-Mari
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing. Region Halland, Halmstad, Sweden.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Ruland, Cornelia Maria
    The Centre for Shared Decision Making and Collaborative Care Research (CSDM), Oslo University Hospital, Oslo, Norway & University of Oslo, Oslo, Norway.
    Nordby-Bøe, Trude
    The Centre for Shared Decision Making and Collaborative Care Research (CSDM), Oslo University Hospital, Oslo, Norway.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Redesign and Validation of Sisom, an Interactive Assessment and Communication Tool for Children With Cancer2016In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 4, no 2, article id e76Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Children with cancer undergo intensive and long treatment periods that expose them and their families to a number of difficult physical, mental, and social challenges. Empowering children by actively involving them in their care can help them to cope with these challenges. It can, however, be difficult for children to be involved and talk about their illness experiences in a "traditional" conversation with health care professionals, especially for younger children. Sisom (Norwegian acronym "Si det som det er" or "Tell it how it is") is an interactive computer-based assessment and communication tool to give children (aged 6-12 years) with cancer a "voice" in their care. Because of technological advances and widespread use of mobile devices Sisom had to be redesigned to better meet the needs of children of today.

    OBJECTIVE: To redesign Sisom for use on mobile devices and to validate and adapt it for use in a Swedish population of children with cancer.

    METHODS: A user-experience design was used. Content adaptation included forward-backward translation by Swedish and Norwegian translators. Healthy children (n=5), children with experiences of cancer treatment (n=5) and their parents (n=5), and pediatric nurses (n=2) were then involved in culturally adapting Sisom to the Swedish context. The iterative low- and high-fidelity evaluation was supported by a think aloud method, semistructured interviews, and drawings to capture children's views of Sisom. The redesign and evaluation continued until no further changes or improvements were identified by the participants or the researchers.

    RESULTS: Children, parents, and pediatric nurses offered many suggestions for improvements to the original version in terms of content, aesthetics, and usability of Sisom. The most significant change that emerged through user input was a modification that entailed not using problem-focused statements in the assessment items. The parents and pediatric nurses considered the revised assessment items to be general and less diagnosis specific. The evaluation of aesthetics resulted in brighter colors and more positive and exciting details in the animations. The evaluation of usability included improvements of the verbal instructions on how to navigate in Sisom 2, and also that the answers to assessmentitems in Sisom 2 should be saved to provide the children with the option to pause and to continue answering the remaining assessment items at a later stage.

    CONCLUSIONS: Overall, this paper describes the process of using user-experience design with children in order to redesign and validate an interactive assessment and communication tool and how the outcomes of this process resulted in a new version, Sisom 2. All participants confirmed the usability and qualities of using the final version. Future research should be directed toward the implementation of Sisom 2 in clinical practice and to evaluate outcomes from individual and organizational levels.

  • 4.
    Bengtsson, Margareta
    et al.
    Hallands Sjukhus, Halmstad.
    Kvarnhäll, Jennie
    Hallands Sjukhus, Halmstad.
    Svedberg, Petra
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svenska sjuksköterskors upplevelse av handledningsprocessen vid sjuksköterskestudenters verksamhetsförlagda utbildning2011In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 31, no 4, p. 47-51Article in journal (Refereed)
    Abstract [en]

    A central part of the nursing profession is the supervision in clinical practice of nursing students and a consequence of this is that the nurse needs to be prepared and have sufficient knowledge to support student's learning process. The aim of this study was to gain a deeper understanding of nurses' experiences of the supervision of nursing students in clinical practice. Fifteen nurses with experience of being supervisor were interviewed and the data material was analyzed with a Grounded Theory approach. The results comprise a core category “supervision was perceived as developing and stimulation” and four categories; to have sufficient with time, to have a working co-operation, to have sufficient knowledge and to get confirmation. These categories formed a conceptual model explaining the nurse’s experiences of the process of supervision and their needs of time, co-operation, knowledge and confirmation if the supervision should be perceived as developing and stimulating. More research needs to be conducted to expand the perspective on how supervision education and opportunities for reflection during the clinical education contribute to the student's learning process.

  • 5.
    Brännström, Margareta
    et al.
    Department of Nursing, Umeå University, Umeå, Sweden.
    Kristofferzon, Marja-Leena
    Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden.
    Ivarsson, Bodil
    Department of Cardiothoracic Surgery, Lund University and Skåne University Hospital, Lund, Sweden.
    Nilsson, Ulrica G.
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Thylén, Ingela
    Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Sweden.
    Sexual Knowledge in Patients With a Myocardial Infarction and Their Partners2014In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 29, no 4, p. 332-339Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Sexual health and sexual activity are important elements of an individual's well-being. For couples, this topic is often affected after a myocardial infarction (MI). It has become increasingly clear that, after an MI, patients are insufficiently educated on how to resume normal sexual activity. However, sufficient data on the general knowledge that patients and partners have about sexual activity and MI are lacking.

    OBJECTIVE: The aims of this study were to explore and compare patients' and partners' sexual knowledge 1 month after a first MI and 1 year after the event and to compare whether the individual knowledge had changed over time. A second aim was to investigate whether patients and their partners report receiving information about sexual health and sexual activity from healthcare professionals during the first year after the event and how this information was perceived.

    SUBJECTS AND METHODS: This descriptive, comparative survey study enrolled participants from 13 Swedish hospitals in 2007-2009. A total of 115 patients with a first MI and their partners answered the Sex After MI Knowledge Test questionnaire 1 month after the MI and 1 year after the event. Correct responses generated a maximum score of 75. RESULTS:: Only 41% of patients and 31% of partners stated that they had received information on sex and relationships at the 1 year follow-up. The patients scored 51 ± 10 on the Sex After MI Knowledge Test at inclusion into the study, compared with the 52 ± 10 score for the partners. At the 1-year follow-up, the patients' knowledge had significantly increased to a score of 55 ± 7, but the partners' knowledge did not significantly change (53 ± 10).

    CONCLUSIONS: First MI patients and their partners reported receiving limited information about sexual issues during the cardiac rehabilitation and had limited knowledge about sexual health and sexual activity.

  • 6.
    Carlsson, Ing-Marie
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Patient participation, a prequisite for care: A grounded theory study of healthcare professionals’ perceptions of what participation means in a paediatric care context2018In: Nursing Open, E-ISSN 2054-1058, Vol. 5, no 1, p. 45-52Article in journal (Refereed)
    Abstract [en]

    Aims

    To explore healthcare professionals’ perceptions of what patient participation means in a paediatric care context.

    Design

    A qualitative explorative design with grounded theory.

    Methods

    Fifteen healthcare professionals who worked in paediatric care settings were either interviewed or asked open-ended questions in a survey, during December 2015–May 2016. Grounded theory was used as a method.

    Results

    The study results provide a theoretical conceptualization of what patient participation meant for healthcare professionals in paediatric care and how participation was enabled. The core category “participation a prerequisite for care” emerged as the main finding explaining the concept as ethical, practical and integrated in the care givers way of working. However, the concept was implicit in the organization. Four additional categories illustrated the healthcare professionals’ different strategies used to enhance patient participation; “meeting each child where the child is,” “building a relationship with the child,” “showing respect for each individual child” and “making the most of the moment.” © 2017 The Authors. Nursing Open published by John Wiley & Sons Ltd

  • 7.
    Dahlqvist Jönsson, Patrik
    et al.
    Region Halland, Halmstad, Sweden.
    Sandlund, Mikael
    Umeå University, Umeå, Sweden.
    Schön, Ulla-Karin
    Dalarna University, Falun, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    The meaning of Shared decision making for persons with long-term mental illness2013In: Breaking barriers 2013, 2013, p. 19-19Conference paper (Refereed)
  • 8.
    Dahlqvist Jönsson, Patrik
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Department of Research, Development and Education (FoUU), Region of Halland, Halmstad, Sweden.
    Schön, Ulla-Karin
    School of Health and Social Work, Dalarna University, Falun, Sweden.
    Rosenberg, David
    Umeå University, Umeå, Sweden.
    Sandlund, Mikael
    Umeå University, Umeå, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Service users’ experiences of participation in decision making in mental health services2015In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 22, no 9, p. 688-697Article in journal (Refereed)
    Abstract [en]

    Service user participation in decision making is considered an essential component of recovery-oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core category that emerged in the analysis described a ‘struggle to be perceived as a competent and equal person’ while three related categories including being the underdog, being controlled and being omitted described the difficulties of participating in decisions. The data analysis resulted in a model that describes internal and external conditions that influence the promotion of participation in decision making. The findings offer new insights from a user perspective and these can be utilized to develop and investigate concrete methods in order to promote user's participation in decisions. © 2015 John Wiley & Sons Ltd.

  • 9.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Kadrija, Ibadete
    Halmstad University, School of Social and Health Sciences (HOS).
    Brunt, David
    Institutionen för Hälsa och Vårdvetenskap, Linnéuniversitetet, Växjö, Sweden.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Psychometric evaluation of a Swedish version of Minneapolis-Manchester quality of life-youth form and adolescent form2013In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 11, article id 79Article in journal (Refereed)
    Abstract [en]

    Background: It has become important to measure long-term effects and quality of life in survivors of childhood cancer. The Minneapolis- Manchester Quality of Life (MMQL) instrument has been proven to better capture the quality of life (QoL) perspective of health than other instruments. The instrument has age appropriate versions and is therefore favourable for longitudinal studies of QoL of children surviving from cancer. The aim of this study was to evaluate the psychometric properties of the Swedish version of MMQL-Youth Form and the Adolescent Form focusing on: 1) face and content validity 2) the internal consistency and 3) the test-retest reliability. Methods: The sample consisted of 950 pupils (11–16years old) from 7 schools in the western Sweden who completed the questionnaire. For the test-retest evaluation 230 respondents completed the questionnaire two weeks later. Results: Face and content validity was supported and internal consistency was found to be acceptable for the total scale for both the MMQL-Youth Form (8–12years of age) and the Adolescent Form (13–20years of age). Test-retest reliability for the MMQL-Youth Form was moderate for 50% of the items and good for the remaining. For the MMQL-Adolescent Form the test-retest showed moderate or good agreement for 80% of the items and fair for 20%. Conclusions: The result indicated that the Swedish version of the MMQLYouth Form and Adolescent Form was valid and reliable in a sample of healthy children in a Swedish context. It is recommended to test the instrument among diverse samples of children such as survivors of childhood cancer in order to validate its usefulness in research and clinical settings. © 2013 Einberg et al.; licensee BioMed Central Ltd.

  • 10.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Enskär, Karin
    Jönköping University, Jönköping, Sweden.
    'Through my eyes': children with experience of cancer describing through photography what promotes their health2014In: Health Promotion Research - An International Forum <<Next Health>>, August 25-27,  2014, Trondheim, Norway, Trondheim: Senter for helsefremmende forskning HiST/NTNU , 2014, p. 33-33Conference paper (Refereed)
  • 11.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Enskär, Karin
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    ‘Through my eyes’: health-promoting factors described by photographs taken by children with experience of cancer treatment2016In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 42, no 1, p. 76-86Article in journal (Refereed)
    Abstract [en]

    Background

    Health promotion for children with cancer should be based on the children's own needs and desires. Because there is a lack of knowledge in this area, the aim of this study was to explore what promotes health from the perspective of children with experience of cancer treatment.

    Methods

    Fifteen children between 8 and 12 years of age participated in focus groups with three children in each group. The children were given a camera and instructions to photograph subjects that promote their health. Focus group discussions were based on the photographs and the children's own description of those photographs. The analysis of focus group discussions and photographs was conducted using inductive content analysis.

    Results

    According to the children, health-promoting factors are defined as meaningful relationships, recreational activities and a trustful environment. Meaningful relationships include togetherness within the family, affection for pets and friendship with peers. Recreational activities include engagement in play and leisure, withdrawal for relaxation and feeling enjoyment. Trustful environment includes confidence in significant others and feeling safe.

    Conclusions

    Knowledge from this study can contribute to health promotion interventions and quality improvements in the health care of children with experience of cancer treatment. Children's experiences with what promotes health in their everyday lives provide a better understanding of the type of support children prefer when promoting their own health. © 2015 John Wiley & Sons Ltd.

  • 12.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Enskär, Karin
    Hälsohögskolan i Jönköping, Jönköping, Sweden.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Friendship from the perspective of children with experience of cancer: A focus group study2013In: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 60, no suppl. 3, p. 43-43Article in journal (Refereed)
  • 13.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Enskär, Karin
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Friendship Relations From the Perspective of Children With Experience of Cancer Treatment: A Focus Group Study With a Salutogenic Approach2015In: Journal of Pediatric Oncology Nursing, ISSN 1043-4542, E-ISSN 1532-8457, Vol. 32, no 3, p. 153-164Article in journal (Refereed)
    Abstract [en]

    Friendships are significant to child development and health but diseases such as cancer can interrupt the contact with friends. The purpose of this study was to describe perceptions of friendship from the perspective of children undergoing cancer treatment, in order to build knowledge that can be used in a health promotion intervention for these children. Fifteen children between 8 and 12 years of age participated in focus groups, where a mixture of informative and creative techniques were used. The focus group discussions were analyzed using qualitative content analysis. The analysis resulted in three generic categories, “Common interests and experiences,” “Mutual empathic actions.” and “Mutual trust and understanding,” incorporating seven subcategories. Based on children’s descriptions from a salutogenic perspective, friendship emerged as An equal and mutual commitment that evolves over time and with interactions face-to-face and digitally, a child perspective on friendship should be central to the development of health promotion interventions designed to support friendship relations of children treated for cancer. © 2014 by Association of Pediatric Hematology/Oncology Nurses

  • 14.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Wärnestål, Pontus
    Thomsen, Michel
    Stigmar, Jennie
    Barnonkologiskt centra, Skånes Universitetssjukhus i Lund, Lund, Sverige.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, Jönköping, Sverige.
    Åkesson, Maria
    Nygren, Jens
    Hur gör man barn delaktiga i forsknings- och innovationsprocesser vid utveckling av digitala hälsoinnovationer2013Conference paper (Refereed)
    Abstract [sv]

    Att drabbas av en svår eller kronisk sjukdom under barndomen kan bidra till fysiska och psykosociala svårigheter senare i livet. Kamratstöd mellan individer som delar samma erfarenhet är en viktig främjande faktor till hälsa och välbefinnande och kan verka som en buffert mot stress och motgångar. Empirisk evidens som kan vägleda utveckling av digitala och interaktiva lösningar för kamratstöd mellan barn som drabbas av sjukdom i skolåldern är idag begränsad. Den process som presenteras här är fokuserad på att etablera metodologi för barns delaktighet i innovationsprocesser och att fånga barns bakomliggande beteenden och mål relaterat till kamratstödjande processer och hälsa. Intervjuer i fokusgrupper är en teknik som främjar barns deltagande och fångar barns perspektiv, förståelse och erfarenhet relaterat till deras hälsa. Friska barn (8-12 år) rekryterades från en lokal grundskola till fyra fokusgrupper med fyra barn i varje grupp. Barnen träffades två gånger med en intervall på 1-2 veckor. Förändringar gjordes mellan varje fokusgrupp för att anpassa strukturen på träffarna till en nivå motsvarande barnens erfarenheter, ålder och förmåga och för att fokusera diskussionerna på innovationsprocessen. En blandning av informativa och kreativa tekniker som öppna frågor, brainstorming, rita och måla och fotografering användes för att underlätta för barnen att uttrycka sig. Barnen framförde efter deltagandet att de tyckte om att delta och ville träffas igen i den här formen av grupp. Vår anpassade struktur på fokusgrupper används idag med barn med erfarenhet av svår sjukdom (cancer) för att ta fram typanvändare (Personas) i innovationsprocessen. Barnen rekryterades från Barnonkologiskt centra i Lund och Hallands sjukhus i Halmstad till fem fokusgrupper med tre barn i varje grupp. Barns delaktighet genom vår metod har förbättrat förutsättningarna att fånga barns mål och beteende och tillfört unikt material till den fortsatta designprocessen.

  • 15.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Wärnestål, Pontus
    Halmstad University, School of Information Science, Computer and Electrical Engineering (IDE), Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Thomsen, Michel
    Halmstad University, School of Information Science, Computer and Electrical Engineering (IDE), Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Stigmar, Jennie
    Barnonkologiskt centra, Skånes Universitetssjukhus i Lund, Lund, Sverige.
    Enskär, Karin
    Avd. för omvårdnad, Hälsohögskolan, Högskolan i Jönköping, Jönköping, Sverige.
    Åkesson, Maria
    Halmstad University, School of Information Science, Computer and Electrical Engineering (IDE), Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Nygren, Jens
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Hur gör man barn delaktiga i forsknings- och innovationsprocesser vid utveckling av digitala hälsoinnovationer2012Conference paper (Refereed)
    Abstract [sv]

    Att drabbas av en svår eller kronisk sjukdom under barndomen kan bidra till fysiska och psykosociala svårigheter senare i livet. Kamratstöd mellan individer som delar samma erfarenhet är en viktig främjande faktor till hälsa och välbefinnande och kan verka som en buffert mot stress och motgångar. Empirisk evidens som kan vägleda utveckling av digitala och interaktiva lösningar för kamratstöd mellan barn som drabbas av sjukdom i skolåldern är idag begränsad. Den process som presenteras här är fokuserad på att etablera metodologi för barns delaktighet i innovationsprocesser och att fånga barns bakomliggande beteenden och mål relaterat till kamratstödjande processer och hälsa. Intervjuer i fokusgrupper är en teknik som främjar barns deltagande och fångar barns perspektiv, förståelse och erfarenhet relaterat till deras hälsa. Friska barn (8-12 år) rekryterades från en lokal grundskola till fyra fokusgrupper med fyra barn i varje grupp. Barnen träffades två gånger med en intervall på 1-2 veckor. Förändringar gjordes mellan varje fokusgrupp för att anpassa strukturen på träffarna till en nivå motsvarande barnens erfarenheter, ålder och förmåga och för att fokusera diskussionerna på innovationsprocessen. En blandning av informativa och kreativa tekniker som öppna frågor, brainstorming, rita och måla och fotografering användes för att underlätta för barnen att uttrycka sig. Barnen framförde efter deltagandet att de tyckte om att delta och ville träffas igen i den här formen av grupp. Vår anpassade struktur på fokusgrupper används idag med barn med erfarenhet av svår sjukdom (cancer) för att ta fram typanvändare (Personas) i innovationsprocessen. Barnen rekryterades från Barnonkologiskt centra i Lund och Hallands sjukhus i Halmstad till fem fokusgrupper med tre barn i varje grupp. Barns delaktighet genom vår metod har förbättrat förutsättningarna att fånga barns mål och beteende och tillfört unikt material till den fortsatta designprocessen.

  • 16.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Wärnestål, Pontus
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Thomsen, Michel
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS).
    Stigmar, Jennie
    Barnonkologiskt centra, Skånes Universitetssjukhus i Lund, Sverige.
    Enskär, Karin
    Högskolan i Jönköping, Hälsohögskolan, Avd. för omvårdnad, Jönköping, Sverige.
    Åkesson, Maria
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS).
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Involving children in research and innovation processes in the development of digital health promotion intervention2013Conference paper (Refereed)
    Abstract [en]

    Introduction

    Severe or chronic illness in childhood may contribute to physical and psychosocial problems later in life. Peer support among individuals who share the same experience is an important factor in promoting health and wellbeing and can act as a buffer against stress and adversities. Empirical evidence that could guide development of digital and interactive solutions for peer support between school-aged children affected by illness is limited.

    Purpose/Methods

    The process presented here is focused on establishing method- ology for children's participation in innovation processes and to capture the child's underlying behaviors and goals related to peer support processes and health. Focus group interview is a child-friendly method that promotes participation and access to children's perspectives, insights and experiences related to their health. Healthy children were recruited from a local elementary school. Focus groups were carried out in two sessions for each group with an interval of 1-2 weeks.

    Results

    Adjustments were made between each focus group to adapt the meeting structure to a level commensurate with the chil- dren's experience, age and abilities and to focus discussions on innovation incentives related to a digital peer support service. A mixture of informative and creative techniques such as open questions, brainstorming, drawing and painting and photog- raphy were used to assist the children to express themselves. The children were pleased to participate and wanted to meet again in this form of group.

    Conclusions

    Our adapted focus group structure are now being used with children with experience of severe illness (cancer) to develop Personas (fictitious characters of users) in the innovation pro- cess. Children's participation through our method has improved the chances of capturing children's goals and behavior, and added unique material for the continuing design process. 

  • 17.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Wärnestål, Pontus
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Thomsen, Michel
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Stigmar, Jennie
    Skåne University Hospital, Lund, Sweden.
    Enskär, Karin
    Jönköping University, Jönköping, Sweden.
    Åkesson, Maria
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), Man and Information technology laboratory (MI-lab).
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Participatory innovation process for development of a digital peer support service for children with cancer2012In: SIOP Publication Abstracts, Hoboken, NJ: John Wiley & Sons, 2012, p. 88-88Conference paper (Refereed)
    Abstract [en]

    Purpose: Surviving cancer during childhood imposes a number of difficulties later in life. Peer support has been recognised as an important contributor to health and well-being but empirical evidence that could guide development of peer support programs for school aged children is scarce. The process presented here is focused on generic exploration of children’s needs and expectations related to peer support innovations to promote health and wellbeing of children with cancer. The purpose of this study is to establish a participatory innovation process that grasps the underlying behaviours and goals of children that will affect the design of a digital peer support service.

    Methods: Focus group interview is a child-friendly technique that promotes participation and access to children’s perspectives, insights and experiences related to their health. Healthy children 8–12 years of age were recruited from a local elementary school. Focus groups (n = 5 groups) were carried out in two sessions for each group (n = 4 children per group) with an interval of 1–2 weeks. Adjustments were made between each focus group to adapt the meeting structure to a level commensurate with the children’s experience, age and abilities and to focus discussions on innovation incentives related to a digital peer support service.

    Results: The adaptation process involved adjustments of the focus group structure to match children in the selected age group and to the aims of the innovation process. A mixture of informative and creative techniques (open questions, brainstorming, drawing, photography) assisted the children in talking and expressing themselves. The children were pleased to participate and wanted to meet again in this kind of study group. The adapted focus group sessions are now being used in the research and innovation process with children (8–12 yrs) with experience of cancer treatment.

    Conclusion: The final focus group structure capture children’s perspectives for the design of a digital peer support service.

  • 18.
    Einberg, Eva-Lena
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Wärnestål, Pontus
    Thomsen, Michel
    Stigmar, Jennie
    Enskär, Karin
    Åkesson, Maria
    Nygren, Jens Martin
    Participatory innovation process for development of a digital peer support service for children with cancer2012In: NOPHO NOBOS Meeting and Congress Uppsala, Sweden, May 19 – 22, 2012: Programme and Abstract Book, 2012, p. 118-118Conference paper (Refereed)
  • 19.
    Garell, Cecilia
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    A Legal Framework to Support Development and Assessment of Digital Health Services2016In: JMIR medical informatics, ISSN 2291-9694, Vol. 4, no 2, p. e17-e17Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Digital health services empower people to track, manage, and improve their own health and quality of life while delivering a more personalized and precise health care, at a lower cost and with higher efficiency and availability. Essential for the use of digital health services is that the treatment of any personal data is compatible with the Patient Data Act, Personal Data Act, and other applicable privacy laws.

    OBJECTIVE: The aim of this study was to develop a framework for legal challenges to support designers in development and assessment of digital health services.

    METHODS: A purposive sampling, together with snowball recruitment, was used to identify stakeholders and information sources for organizing, extending, and prioritizing the different concepts, actors, and regulations in relation to digital health and health-promoting digital systems. The data were collected through structured interviewing and iteration, and 3 different cases were used for face validation of the framework.

    RESULTS: A framework for assessing the legal challenges in developing digital health services (Legal Challenges in Digital Health [LCDH] Framework) was created and consists of 6 key questions to be used to evaluate a digital health service according to current legislation.

    CONCLUSIONS: Structured discussion about legal challenges in relation to health-promoting digital services can be enabled by a constructive framework to investigate, assess, and verify the digital service according to current legislation. The LCDH Framework developed in this study proposes such a framework and can be used in prospective evaluation of the relationship of a potential health-promoting digital service with the existing laws and regulations.

  • 20.
    Garell, Cecilia
    et al.
    Halmstad University, School of Health and Welfare.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Lagutrymmet för hälsofrämjande e-tjänster i förhållande till hälso- och sjukvården2014Report (Other academic)
  • 21.
    Gilljam, Britt-Mari
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Arvidsson, Susann
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Involving Children with Juvenile Idiopathic Arthritis in Health-Related Research – Why and How?2015In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 74, no Suppl. 2, p. 1312-1312Article in journal (Refereed)
    Abstract [en]

    Background: Children with severe Juvenile idiopathic arthritis (JIA) are exposed to care situations and harsh treatments such as intra-articular corticosteroid injections (1). In order for these children to feel confidence, it is important they understand and feel they have control over the situation. To support the wellbeing of these children and their involvement in care, it is important to investigate their views of the care process and their everyday life (2).

    Objectives: The purpose of this study is to describe our experiences of using different activities and techniques during interviews with children with JIA.

    Methods: Children (n=23) from two rheumatic pediatric clinics in Sweden, age 8 - 17, diagnosed with JIA since at least two years were interviewed individually or in focus groups. All interviews focused on experiences and preferences of participating in care situations. Among the younger children, age 8 - 12, we used activities such as sentence completion, to express three wishes, draw and tell, and role-play with Barbie dolls. Among the older ones, age 13 – 17, we used sentence completion, to express three wishes and post-IT tabs for brainstorming and subsequent discussion. During all interviews we used open-ended questions.

    Results: Sentence completion and three wishes were two weak techniques for most of the children regardless of age. The younger children often responded to these techniques with silence or responses like “I don't know”. The older children responded with intense reflection and thinking, and predominately came up with one wish only. Techniques that were powerful in activating discussions were draw and tell and role-play with Barbie dolls for the younger children. Using Post-IT tabs and discussions was a good starter for discussions for the older children in focus groups.

    Conclusions: There is reason to reflect on what techniques researchers use when interviewing children, as the prospects of capturing children's perspectives in research is largely dependent on the researcher's ability to engage children in the interview situation. Different interview methods should be used depending on the age of the informants, the purpose of the investigation, and the capabilities, such as the health status, of the child. In this study, we experienced that the participants ability to express their experiences and preferences can be facilitated with practical techniques, like drawing and role-play with Barbie dolls for younger children and Post-IT tabs for children in older age groups.

    References:

    Bertilsson L. Andersson-Gäre B. Fasth A. Forsblad-d'Elia H. A 5-year prospective population-based study of juvenile chronic arthritis: onset, disease process, and outcome. Scandinavian journal of rheumatology 2012; 41(5): 379-382.

    Coyne I. Hayes E. Gallagher P. Regan G. Giving children a voice: investigation of children's experiences of participation in consultation and decision-making in Irish hospitals. Office of the Minister for Children 2006; 3576.

    Acknowledgements: Thanks to: The Swedish Rheumatic Foundation, Stig Thunes Foundation and Norrbacka Eugenia Foundation.

    Disclosure of Interest: None declared

  • 22.
    Gilljam, Britt-Mari
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Arvidsson, Susann
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Promoting participation in healthcare situations for children with JIA: a grounded theory study2016In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, article id 30518Article in journal (Refereed)
    Abstract [en]

    Children’s right to participate in their own healthcare has increasingly become highlighted in national and international research as well as in government regulations. Nevertheless, children’s participation in healthcare is unsatisfactorily applied in praxis. There is a growing body of research regarding children’s participation, but research from the children’s own perspective is scarce. The aim of this study was thus to explore the experiences and preferences for participation in healthcare situations among children with juvenile idiopathic arthritis (JIA) as a foundation for creating strategies to promote their participation in pediatric healthcare. Twenty children, aged 8 to 17 years, with JIA were interviewed individually and in focus groups. In order to increase the children’s opportunities to express their own experiences, different interview techniques were used, such as draw-and-tell and role play with dolls. The analysis was conducted with a constructivist grounded theory. The result explores children’s perspective of influencing processes promoting their participation in healthcare situations. The core category that emerged was, “Releasing fear and uncertainty opens up for confidence and participation,” and the categories related to the core category are, “surrounded by a sense of security and comfort,” and “strengthened and supported to become involved.” In conclusion, the knowledge gained in this study offers new insights from the perspective of children themselves, and can constitute a valuable contribution to the understanding of necessary conditions for the development of specific interventions that promote participation among children in healthcare situations.

  • 23.
    Grim, Katarina
    et al.
    Karlstad University, Faculty of Arts and Social Sciences (starting 2013), Department of Social and Psychological Studies (from 2013).
    Rosenberg, David
    Umeå universitet.
    Svedberg, Petra
    Högskolan Halmstad.
    Schon, Ulla-Karin
    Högskolan Dalarna.
    Development and Usability Testing of a Web-Based Decision Support for Users and Health Professionals in Psychiatric Services2017In: Psychiatric rehabilitation journal, ISSN 1095-158X, E-ISSN 1559-3126, Vol. 40, no 3, p. 293-302Article in journal (Refereed)
    Abstract [en]

    Objective: Shared decision making (SMD) related to treatment and rehabilitation is considered a central component in recovery-oriented practice. Although decision aids are regarded as an essential component for successfully implementing SDM, these aids are often lacking within psychiatric services. The aim of this study was to use a participatory design to facilitate the development of a user-generated, web-based decision aid for individuals receiving psychiatric services. The results of this effort as well as the lessons learned during the development and usability processes are reported. Method: The participatory design included 4 iterative cycles of development. Various qualitative methods for data collection were used with potential end users participating as informants in focus group and individual interviews and as usability and pilot testers. Results: Interviewing and testing identified usability problems that then led to refinements and making the subsequent prototypes increasingly user-friendly and relevant. In each phase of the process, feedback from potential end-users provided guidance in developing the formation of the web-based decision aid that strengthens the position of users by integrating access to information regarding alternative supports, interactivity between staff and users, and user preferences as a continual focus in the tool. Conclusions and Implications for Practice: This web-based decision aid has the potential to strengthen service users' experience of self-efficacy and control as well as provide staff access to user knowledge and preferences. Studies employing participatory models focusing on usability have potential to significantly contribute to the development and implementation of tools that reflect user perspectives.

  • 24.
    Grim, Katarina
    et al.
    Dalarna University, Falun, Sweden.
    Rosenberg, David
    Umeå University, Umeå, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Schön, Ulla-Karin
    Stockholm University, Stockholm, Sweden.
    Development- and testing of a web-based decision support for users and health professionals in psychiatric services2017In: ENMESH: Groningen 2017: Abstractbook, 2017, p. 48-48Conference paper (Refereed)
    Abstract [en]

    Aim: Shared decision making (SDM) is considered a central component in a recovery-oriented practice. While decision aids are often regarded as an essential component for successfully implementing SDM they are still largely lacking within psychiatric services.

    The aim of this study was to utilize a participatory design in order to facilitate the development of a user-generated, web-based decision aid for individuals receiving psychiatric services. The results of this effort as well as the lessons learned during the developmental- and usability processes are reported.

    Methods: The participatory design included 4 iterative cycles of development. Various qualitative methods for data collection were employed with potential end users who participated as informants in focus group interviews and individual interviews, and as usability and pilot testers.

    Results: Interviewing and testing identified usability problems which led to refinements making the subsequent prototypes increasingly user friendly and relevant, and which. In each phase of the development process, feedback from potential end-users provided indispensable guidance in the formation of a decision aid for strengthening the position of users by building on an interactive web based environment.

    Conclusions: The decision aid which resulted from this process has the potential to strengthen service users’ experience of self-efficacy and control as well as giving staff access to user knowledge and preferences. Studies employing participatory models focusing on usability have potential to significantly contribute to developing and implementing tools that reflect user perspectives.

  • 25.
    Grim, Katarina
    et al.
    Dalarna University, Falun, Sweden.
    Rosenberg, David
    Umeå University, Umeå, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Schön, Ulla-Karin
    Dalarna University, Falun, Sweden.
    Development and Usability Testing of a Web-Based Decision Support for Users and Health Professionals in Psychiatric Services2017In: Psychiatric rehabilitation journal, ISSN 1095-158X, E-ISSN 1559-3126, Vol. 40, no 3, p. 293-302Article in journal (Refereed)
    Abstract [en]

    Objective: Shared decision making (SMD) related to treatment and rehabilitation is considered a central component in recovery-oriented practice. Although decision aids are regarded as an essential component for successfully implementing SDM, these aids are often lacking within psychiatric services. The aim of this study was to use a participatory design to facilitate the development of a user-generated, web-based decision aid for individuals receiving psychiatric services. The results of this effort as well as the lessons learned during the development and usability processes are reported.

    Method: The participatory design included 4 iterative cycles of development. Various qualitative methods for data collection were used with potential end users participating as informants in focus group and individual interviews and as usability and pilot testers.

    Results: Interviewing and testing identified usability problems that then led to refinements and making the subsequent prototypes increasingly user-friendly and relevant. In each phase of the process, feedback from potential end-users provided guidance in developing the formation of the web-based decision aid that strengthens the position of users by integrating access to information regarding alternative supports, interactivity between staff and users, and user preferences as a continual focus in the tool.

    Conclusions and implications for practice: This web-based decision aid has the potential to strengthen service users' experience of self-efficacy and control as well as provide staff access to user knowledge and preferences. Studies employing participatory models focusing on usability have potential to significantly contribute to the development and implementation of tools that reflect user perspectives. © 2017 APA, all rights reserved.

  • 26.
    Grim, Katarina
    et al.
    Dalarna University, Falun, Sweden.
    Rosenberg, David
    Umeå University, Umeå, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Schön, Ulla-Karin
    Dalarna University, Falun, Sweden.
    Shared decision-making in mental health care – A user perspective on decisional needs in community-based services2016In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, article id 30563Article in journal (Refereed)
    Abstract [en]

    Background: Shared decision-making (SDM) is an emergent research topic in the field of mental health care and is considered to be a central component of a recovery-oriented system. Despite the evidence suggesting the benefits of this change in the power relationship between users and practitioners, the method has not been widely implemented in clinical practice.

    Objective: The objective of this study was to investigate decisional and information needs among users with mental illness as a prerequisite for the development of a decision support tool aimed at supporting SDM in community-based mental health services in Sweden.

    Methods: Three semi-structured focus group interviews were conducted with 22 adult users with mental illness. The transcribed interviews were analyzed using a directed content analysis. This method was used to develop an in-depth understanding of the decisional process as well as to validate and conceptually extend Elwyn et al.’s model of SDM.

    Results: The model Elwyn et al. have created for SDM in somatic care fits well for mental health services, both in terms of process and content. However, the results also suggest an extension of the model because decisions related to mental illness are often complex and involve a number of life domains. Issues related to social context and individual recovery point to the need for a preparation phase focused on establishing cooperation and mutual understanding as well as a clear follow-up phase that allows for feedback and adjustments to the decision-making process.

    Conclusions and Implications for Practice: The current study contributes to a deeper understanding of decisional and information needs among users of community-based mental health services that may reduce barriers to participation in decision-making. The results also shed light on attitudinal, relationship-based, and cognitive factors that are important to consider in adapting SDM in the mental health system.

  • 27.
    Grim, Katarina
    et al.
    The County Council of Värmland, Karlstad, Sweden.
    Schön, Ulla-Karin
    Dalarna University, Falun, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Rosenberg, David
    Umeå University, Umeå, Sweden.
    Exploring psychiatric users’ decisional and information needs in Shared Decision Making in the light of Elwyn´s three-step model for Clinical practice2015In: Closing the gap between research and policy in mental health: Book of abstracts / [ed] Fase20 S.L., Málaga: ENMESH , 2015, p. 118-119Conference paper (Refereed)
    Abstract [en]

    Introduction: Using medication and participating in psychosocial interventions are active processes that often involve complex decision-making. Shared decision making, SDM, provides a model for user and practitioner to cooperatively assess a treatment’s advantages and disadvantages. Decision aid tools adapted to the needs of users have the potential to restructure how people with mental illness and staff work together to arrive at shared decisions about the next steps in treatment or support.

    Aims: The objective of this study is to investigate decisional and information needs among users with mental illness as a pre-requisite for the design and development of a decision aid aimed at supporting user participation in SDM.

    Methods: Needs and preferences regarding information transfer in SDM were explored through semi-structured focus group interviews. Participants were adults with psychiatric diagnoses and experience of psychiatric services or close relatives to someone with a psychiatric illness.Qualitative content analysis was used to analyze the data. The transcriptions were initially analyzed in accordance with a conventional, inductive approach. A directed content analysis was then utilized, with Elwyn’s three step model for SDM as a theoretical framework from which to further operationalize the categories rendered in the first step of analysis.

    Results: The majority of the findings were easily integrated within Elwyn ́s categories. However, some elements which emerged in the data and which are worth noting were not encompassed within Elwyn’s model, such as the wish for information prior to the meeting regarding the time frame and agenda. The importance of heeding the prior knowledge of the user as valuable for the decision process and not solely checking it in order to correct possible misinformation was frequently expressed, as was the value of follow-ups.

    Conclusions: Even though Elwyn’s model is constructed as a pedagogic tool to be used by staff, while our focus is directed towards creating a tool for users, the application of the model upon our data was indeed helpful in rendering clearly defined and distinguishable codes from our categories. We therefore consider it to be a suitable model to continue to build upon in the development of a decision aid.

  • 28.
    Grimm, Katarina
    et al.
    Karlstad University, Karlstad, Sweden.
    Rosenberg, David
    Umeå University, Umeå, Sweden.
    Schön, Ulla-Karin
    University of Dalarna, Falun, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Shared decision making in community mental health services: Supporting user needs for information and participation2016Conference paper (Refereed)
    Abstract [en]

    Objectives: Shared decision making (SDM) is a central component in a recovery-oriented practice. While decision aids are essential for implementing SDM, they are still lacking within psychiatric services. The aim of this study was to develop a user-generated, web-based decision aid to support shared decision making in Swedish mental health services.

    Methods: A decision aid was developed and tested in a preliminary study using a community-based participatory design. This digital tool was then included in a multifaceted intervention study which included staff training and an implementation study that included process and impact evaluation.

    Results: Models created for SDM in somatic care, fit well for mental health services. However, the results also suggest adaptations since decisions related to mental illness are often complex and involve multiple life domains. Issues related to social context and individual recovery point to a focus on establishing cooperation as well as follow-up over time.

    Conclusions: The study contributes to an understanding of decisional and information needs, as well as relationship-based and cognitive factors important to consider in adapting SDM in the community mental health system. The decision aid which resulted can strengthen service users’ experience of self-efficacy and control as well as giving staff access to user knowledge and preferences.

  • 29.
    Hansson, Lars
    et al.
    Lunds Universitet.
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svensson, Bengt
    Lunds Universitet.
    Mental health professionals’ attitudes towards people with mental illness: Do they differ from attitudes held by people with mental illness?2011In: International Journal of Social Psychiatry, ISSN 0020-7640, E-ISSN 1741-2854Article in journal (Refereed)
    Abstract [en]

    AIMS: Studies investigating mental health professionals' attitudes towards people with mental illness are scarce and there is a lack of comparative studies including both patients' and mental health professionals' attitudes. The aim of the present study was to investigate mental health staff's attitudes towards people with mental illness and compare these with the attitudes of patients in contact with mental health services. A further aim was to relate staff attitudes to demographic and work characteristics.

    METHODS: A cross-sectional study was performed including 140 staff and 141 patients. The study included a random sample of outpatients in contact with mental health services in the southern part of Sweden and staff working in these services. Attitudes were investigated using a questionnaire covering beliefs of devaluation and discrimination of people with a mental illness.

    RESULTS: Negative attitudes were prevalent among staff. Most negative attitudes concerned whether an employer would accept an application for work, willingness to date a person who had been hospitalized, and hiring a patient to take care of children. Staff treating patients with a psychosis or working in inpatient settings had the most negative attitudes. Patient attitudes were overall similar to staff attitudes and there were significant differences in only three out of 12 dimensions. Patients' most negative attitudes were in the same area as the staff's.

    CONCLUSIONS: This study points to the suggestion that mental health care staff may hold negative attitudes and beliefs about people with mental illness with tentative implications for treatment of the patient and development and implementation of evidence-based services. Since patients and staff in most respects share these beliefs, it is essential to develop interventions that have an impact on both patients and staff, enabling a more recovery-oriented staff-patient relationship.

  • 30.
    Hedelin, Birgitta
    et al.
    Karlstad Universitet.
    Jormfeldt, Henrika
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Hälsobegreppet: synen på hälsa och sjuklighet2014In: Omvårdnadens grunder: perspektiv och förhållningssätt / [ed] Febe Friberg & Joakim Öhlén, Lund: Studentlitteratur AB, 2014, 2, p. 361-385Chapter in book (Other academic)
  • 31.
    Hedelin, Birgitta
    et al.
    Karlstads universitet, Karlstad, Sverige.
    Jormfeldt, Henrika
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI), Group for Research on health promotion and disease prevention.
    Svedberg, Petra
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI), Group for Research on health promotion and disease prevention.
    Hälsobegreppet: synen på hälsa och sjuklighet2009In: Omvårdnadens grunder: Perspektiv och förhållningssätt / [ed] Febe Friberg & Joakim Öhlén, Lund: Studentlitteratur, 2009, p. 237-260Chapter in book (Other academic)
    Abstract [sv]

    Sjuksköterskan har en unik och central ställning för att genomföra hälsofrämjande arbete. Forskning visar dock att sjuksköterskor i klinisk verksamhet inte alltid är medvetna om att det övergripande målet med omvårdnaden är att stärka patientens hälsa. Fokus i omvårdnaden ligger i stället till stor del på att medverka i behandling av sjukdom. Förståelsen för hur patienten uppfattar sin situation och förmedlar sina behov för att stärka sin hälsa får ofta en mindre framträdande roll. För att omvårdnaden ska bli mer hälsofrämjande behövs ökad kunskap om vad hälsa och hälsofrämjande insatser innebär för den enskilde individen men också för olika grupper i befolkningen. Forskning om hälsofrämjande omvårdnad fokuserar ofta på att förebygga sjukdom. Därför behövs forskning som syftar till att öka hälsofokus i omvårdnaden, både vad det gäller utveckling av grundläggande perspektiv liksom kliniska strategier och modeller för hälsofrämjande omvårdnad på alla nivåer – på såväl individ-, grupp- som samhällsnivån.

  • 32.
    Hutton, Katrin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. Affecta Psychiatric clinic, Halmstad, Sweden.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Low self-rated mental health among Swedish adolescent boys and its relationship to socioeconomic factors2013Conference paper (Refereed)
    Abstract [en]

    Background

    Adolescents mental health is a major public health concern and studies have shown that socioeconomic factors contribute to the experienced health of adolescents. Girls’ mental health, more than boys’ mental health, is often discussed. Therefore, the aim of this study was to investigate the association between self-rated mental health and socioeconomic factors among boys and we hypothesized that household wealth influences the association.

    Methods

    In 2011, a cross-sectional study was conducted at seven junior high schools in a medium sized town in south western Sweden. The data collected was based on a self-administrated questionnaire regarding socioeconomic factors, household wealth and health related quality of life (Minnesota Minneapolis Quality of Life Instrument (MMQL). In all, 235 boys between 11-13 years old and 254 boys between 14-16 years participated. The items from MMQL were summarized into a total score and dichotomized by the median and low self-rated mental health was defined as below median. Logistic regression analysis was used.

    Results

    Among younger boys no association between low self-rated mental health and socioeconomic factors were seen. Among older boys with divorced parents, an increased risk of low mental health rating was seen OR: 1.83 (95%CI, 1.04;3.23), however when adjusting for household wealth the association disappeared (OR;1.76, CI 0.98;3.15). Also, having one or two parents born outside Sweden implied increased risk of a low self-rated mental health OR: 2.0 (CI; 1.15;3.47), which remained when adjusting for household wealth variables (OR; 2.16 CI; 1.17;3.99). Furthermore, having two or more negative socioeconomic variables increased the risk of low rated mental health (OR;2.60, CI 1.15;5.90) the association remained after adjusting for household wealth (OR;2.38, CI 1.03;5.33).

    Conclusions

    Boys with divorced parents, boys from migrant backgrounds and boys with several negative socioeconomic factors constituted the identified subgroups at risk. More research in public health is essential to meet the special needs of different age groups and backgrounds among adolescent boys.

    Key messages

    • Among older boys (14-16 years old) with divorced parents, an increased risk of low mental health rating was seen, however when adjusting for household wealth the association disappeared.
    • Among older boys (14-16 years old) having two or more negative socioeconomic variables increased the risk of low rated mental health, the association remained after adjusting for household wealth.

    © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  • 33.
    Hutton, Katrin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. Affecta psychiatric out-patients clinic, Halmstad, Sweden.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Nygren, Jens
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Kadrija, Ibadete (Contributor)
    Halmstad University, School of Health and Welfare.
    Self-rated mental health and socio-economic background: a study of adolescents in Sweden2014In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, no 1, article id 394Article in journal (Refereed)
    Abstract [en]

    Background: Adolescents' mental health is a major public health issue. Previous research has shown that socio-economic factors contribute to the health status of adolescents. The present study explores the association between socio-economic status and self-rated mental health among adolescents.

    Methods: Cross sectional data from the Halmstad Youth Quality of Life cohort was collected in a town in Sweden. In all, 948 adolescents (11-13 younger age group and 14-16 older age group) participated. Information on self-rated mental health was collected from the subscale Psychological functioning in the Minneapolis Manchester Quality of Life instrument. The items were summarized into a total score and dichotomized by the mean. Indicators measuring socio-economic status (SES) were collected in a questionnaire using the Family Affluence Scale (FAS) and additional factors regarding parents' marital status and migration were added. Logistic models were used to analyze the data.

    Results: Girls were more likely to rate their mental health below the mean compared to boys. With regard to FAS (high, medium, low), there was a significantly increased risk of self-rated mental health below the mean among younger boys in the medium FAS score OR; 2.68 (95% CI 1.35;5.33) and among older boys in the low FAS score OR; 2.37 (1.02;5.52) compared to boys in the high FAS score. No such trend was seen among girls. For younger girls there was a significant protective association between having parents born abroad and self-rated mental health below mean OR: 0.47 (0.24;0.91).

    Conclusions: A complex pattern of associations between SES and self-rated mental health, divergent between age and gender groups, was shown. The total FAS score was only associated with boys' self-rated mental health in both age groups, whereas parents' migratory status influenced only the girls' self-rated mental health. Because of the different association for girls' and boys' self-rated mental health and SES, other factors than SES should also be considered when investigating and exploring the mental health of adolescents in affluent communities. © 2014 Hutton et al.; licensee BioMed Central Ltd.

  • 34.
    Häggström Westberg, Katrin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Affecta Psychiatric Out-Patients Clinic, Halmstad, Sweden.
    Wilhsson, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Morgan, Antony
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Glasgow Caledonian University, Glasgow, United Kingdom.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Optimism as a Candidate Health Asset: Exploring Its Links with Adolescent Quality of Life in Sweden2019In: Child Development, ISSN 0009-3920, E-ISSN 1467-8624, Vol. 90, no 3, p. 970-984Article in journal (Refereed)
    Abstract [en]

    This study aims to understand the role that optimism could play in the context of a health asset approach to promote adolescent health-related quality of life (HRQOL). Adolescents (n = 948), between 11 and 16 years old from a medium-sized rural town in Sweden, answered questionnaires measuring optimism, pessimism, and HRQOL. The findings indicate a significant decrease in optimism and a significant increase in pessimism between early and mid adolescence. The study has allowed us to present associational evidence of the links between optimism and HRQOL. This infers the potential of an optimistic orientation about the future to function as a health asset during adolescence and by implication may provide additional intervention tools in the planning of health promotion strategies. © 2017 The Authors

  • 35.
    Häggström Westerberg, Katrin
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Wilhsson, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Antony, Morgan
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Glasgow Caledonian University, Glasgow, United Kingdom.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Exploring the role of optimism as a protective factor for adolescent quality of lifeManuscript (preprint) (Other academic)
    Abstract [en]

    This study attempts to understand the role that optimism could play in the context of a health asset approach to promote (and protect) adolescent health related quality of life (HRQOL).  Two hypotheses were formulated, a) there is an association between adolescents’ self-rated optimism and pessimism and their HRQOL, (b) age, gender and socio-demographic characteristics influence this association. We explore optimism and pessimism as a bi-dimensional construct and its impact on HRQOL among adolescents in two age groups (11-13 years and 14-16 years). Adolescents answered a self-report questionnaire consisting of two validated scales for measuring HRQOL and the concepts of optimism and pessimism. This study has shown that optimism is an important protective factor for HRQOL and low levels of pessimism were also seen to be protective of HRQOL in both age groups.  This infers the potential of an optimistic orientation about future goals might function as a health asset during adolescence that could be useful in the planning of health promotion strategies.

  • 36.
    Jormfeldt, Henrika
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Brunt, David
    Linnaeus University, School of Health and Caring Sciences, Växjö, Sweden.
    Rask, Mikael
    Linnaeus University, School of Health and Caring Sciences, Växjö, Sweden.
    Bengtsson, Agneta
    Halmstad University, School of Social and Health Sciences (HOS).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Staffs’ experiences of a person-centered health education group intervention for people with a persistent mental illness2013Conference paper (Refereed)
    Abstract [en]

    Patient education in mental health care is a conventional intervention to increase patients' knowledge about their illness and treatment. A provider-centered focus in patient education may put patients in a passive role, which can counteract their processes of recovery. There is an increasing emphasis on recovery-oriented practice, an approach that is aligned with the service user perspective, but little is known about health care staff's perspectives on person-centered mental health care. A qualitative approach was used to describe staff's experiences of being group leaders in a person-centered health education intervention in municipal services for persons with a persistent mental illness. The analysis of staff experiences revealed three core categories: (1) implications of the division of responsibility among local authorities, (2) awareness of facilitating factors of growth, and (3) the meaning of dialogue. These formed the theme Preconditions for Person-Centered Care. Further research is required to explore larger economic, political, and social structures as backdrops to person-centered mental health care, from the perspective of service users, families, health professionals, and the community at large. © 2013 Informa Healthcare USA, Inc.

  • 37.
    Jormfeldt, Henrika
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Brunt, David
    Linnaeus University, School of Health and Caring Sciences, Växjö, Sweden .
    Rask, Mikael
    Linnaeus University, School of Health and Caring Sciences, Växjö, Sweden .
    Bengtsson, Agneta
    Halmstad University, School of Social and Health Sciences (HOS).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Staffs’ experiences of a person-centered health education group intervention for people with a persistent mental illness.2013In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 34, no 7, p. 488-496Article in journal (Refereed)
    Abstract [en]

    Patient education in mental health care is a conventional intervention to increase patients' knowledge about their illness and treatment. A provider-centered focus in patient education may put patients in a passive role, which can counteract their processes of recovery. There is an increasing emphasis on recovery-oriented practice, an approach that is aligned with the service user perspective, but little is known about health care staff's perspectives on person-centered mental health care. A qualitative approach was used to describe staff's experiences of being group leaders in a person-centered health education intervention in municipal services for persons with a persistent mental illness. The analysis of staff experiences revealed three core categories: (1) implications of the division of responsibility among local authorities, (2) awareness of facilitating factors of growth, and (3) the meaning of dialogue. These formed the theme Preconditions for Person-Centered Care. Further research is required to explore larger economic, political, and social structures as backdrops to person-centered mental health care, from the perspective of service users, families, health professionals, and the community at large. © 2013 Informa Healthcare USA, Inc.

  • 38.
    Jormfeldt, Henrika
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Rask, Mikael
    Linnaeus University, Växjö, Sweden.
    Brunt, David
    Linnaeus University, Växjö, Sweden.
    Bengtsson, Agneta
    Psychiatry in Halland, Halmstad, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Experiences of a person-centred health education group intervention - A qualitative study among people with a persistent mental illness2012In: Programme and Abstract Book, Horation: 2nd European Festival of Psychiatric Nursing - in Stockholm 2012 / [ed] Patrik Dahlqvist Jönsson, Psykiatriska Riksföreningen för Sjuksköterskor , 2012Conference paper (Refereed)
    Abstract [en]

    Background: Psychoeducation is an established intervention to increase patients’ knowledge about their illness and treatment in mental health services. Psychoeducational programmes generally have a providercentered focus and the content is usually based on professionals’ perceptions of what knowledge is best suited for the patients. A person-centered health education intervention focuses on personal development and positive dimensions of the individuals’ subjectively experienced health. Furthermore, no study has to our knowledge highlighted the patients’ experiences of person-centered health education in mental health services.

    Aim: The aim of the study was to describe participants’ experiences of a person-centered health education intervention in community mental health care for persons with a persistent mental illness.

    The intervention: The project was carried out in cooperation between the municipal services for persons with psychiatric disabilities and the outpatient specialist psychiatric services in the county. During the autumn of 2008 and the spring of 2009 two person-centered health education groups met on six occasions each term. The content of the sessions were determined by the participants in collaboration with the group leaders and were based on the participants’ preferences containing both theoretical information and practical activities.

    Methods: A qualitative approach was used and the sample consisted of 13 persons who had participated in the group intervention. Data were collected by focus group interviews, which consist of small groups of people who talk about a certain topic lead by a moderator. The data was analyzed with a qualitative content analysis method.

    Results: The findings that emerged from the data could be summarized in the theme “Health processes” consisting of three categories: The first category “Stimulating contents” contained two subcategories, experiencing something more than the average and experiencing variation. Then the category “Towards personal growth” included three subcategories; experiencing the possibility to grow, experiencing courage to do something new and experiencing freedom. Finally the category “Group context with equality” comprised three subcategories; experiencing support, experiencing that you are accepted as you are as well as experiencing that the group is important and to feel important.

    Conclusion: The medical perspective of what causes and cures disease in services for persons with a persistent mental illness could be enriched with an enlarged focus on positive dimensions of health and interventions that aim to promote them. Further research about person-centred interventions should increase to meet the needs of persons with persistent mental illness.

  • 39.
    Jormfeldt, Henrika
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Rask, Mikael
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Brunt, David
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Bengtsson, Agneta
    Psychiatry in Halland, Varberg, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Experiences of a Person-Centred Health Education Group Intervention–A Qualitative Study Among People with a Persistent Mental Illness2012In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 33, no 4, p. 209-216Article in journal (Refereed)
    Abstract [en]

    The main focus of psychoeducative interventions for people with persistent mental illnesses has been on providing information about symptoms of disease and its treatment. Supporting group contexts have been described as essential for the achievement of personal goals. A qualitative approach was used to describe participants’ experiences of a person-centered health education intervention in community mental health care. Participants expressed experiences of health processes in terms of stimulating content, development towards personal growth and group context with equality, when participating in the intervention. The findings support further investigation of health promotion approaches emphasizing individual preferences throughout the process of psychoeducation.

  • 40.
    Jormfeldt, Henrika
    et al.
    Lund University, Sweden.
    Svedberg, Petra
    Lund University, Sweden.
    Hopp: En förutsättning för återhämtning2006In: Psykiatrisk omvårdnad: att stödja hälsofrämjande processer / [ed] Barbro Arvidsson & Ingela Skärsäter, Lund: Studentlitteratur, 2006, p. 169-182Chapter in book (Other academic)
  • 41.
    Jormfeldt, Henrika
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Hälsa och hälsofrämjande arbete i psykiatrisk omvårdnad2014In: Vårdande vid psykisk ohälsa: på avancerad nivå / [ed] Lena Wiklund Gustin, Lund: Studentlitteratur AB, 2014, 2, p. 77-97Chapter in book (Other academic)
  • 42.
    Jormfeldt, Henrika
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Perspektiv på hälsa och ohälsa i psykiatrisk omvårdnad2010In: Vårdande vid psykisk ohälsa: på avancerad nivå / [ed] Wiklund Gustin, Lena, Lund: Studentlitteratur , 2010, p. 63-85Chapter in book (Other (popular science, discussion, etc.))
  • 43.
    Jormfeldt, Henrika
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Arvidsson, Barbro
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Nurses' conceptions of how health processes are promoted in mental health nursing2003In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, E-ISSN 1365-2850, Vol. 10, no 5, p. 608-615Article in journal (Refereed)
    Abstract [en]

    The health and well-being of the individual is a central goal in nursing, and health promotion seeks to enable people to increase control over and improve their health. In mental health care, health is often described in negative terms such as the absence of mental illness, which may create hopelessness and constitute a barrier to a policy of health promotion. The aim of this study was to describe nurses' conceptions of how health processes are promoted in mental health nursing. Twelve nurses working in mental health care were interviewed and the data were analysed using a phenomeographic approach. The nurses expressed 11 different conceptions of the phenomenon, which were summarized into three descriptive categories: presence, balance of power, and focus on health. The findings show that the nurses expressed ambiguous attitudes towards meeting the patient in mental health care. It is suggested that the goal of nursing care should be clarified for nurses in practice, otherwise they may adopt the perspectives of other mental health professionals.

  • 44.
    Jormfeldt, Henrika
    et al.
    Department of Health Sciences, Lund University, Lund.
    Svedberg, Petra
    Department of Health Sciences, Lund University, Lund.
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Perceptions of the concept of health among nurses working in mental health services: a phenomenographic study2007In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 16, no 1, p. 50-56Article in journal (Refereed)
    Abstract [en]

    A new understanding of the concept of health is needed to meet the goal of mental health nursing, which besides reducing disease is to strengthen the patient's health. The aim of the present study was to describe perceptions of the concept of health among nurses working in mental health services. Twelve Swedish nurses working in mental health services were interviewed and data were analysed with a phenomenographic approach. The nurses expressed 10 perceptions, which constituted three description categories: autonomy, process, and participation. The result showed that health was more than absence of disease. Simultaneously, perceptions were expressed indicating that health was viewed as absence of disease, which implies that the concept is not sufficiently defined. The result emphasizes the need to clarify the concept of health if it is to be used as a goal in mental health nursing and to integrate a clarified definition of health at all hierarchical levels in mental health care services.

  • 45.
    Jormfeldt, Henrika
    et al.
    Centrum för evidensbaserade psykosociala insatser för personer med psykiska funktionshinder (CEPI), Lund, Lunds universitet, Sverige.
    Svedberg, Petra
    Centrum för evidensbaserade psykosociala insatser för personer med psykiska funktionshinder (CEPI), Lund, Lunds universitet, Sverige.
    Hansson, Lars
    Centrum för evidensbaserade psykosociala insatser för personer med psykiska funktionshinder (CEPI), Lund, Lunds universitet, Sverige.
    Svensson, Bengt
    Centrum för evidensbaserade psykosociala insatser för personer med psykiska funktionshinder (CEPI), Lund, Lunds universitet, Sverige.
    Utvärdering av rehabiliteringsprojektet. Rapport del 2: Programtrohet och erfarenheter av implementering i psykiatrin i Halland2011Report (Other academic)
  • 46.
    Jormfeldt, Henrika
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svensson, Bengt
    Department of Health Sciences, Lund University, Lund, Sweden.
    Hansson, Lars
    Department of Health Sciences, Lund University, Lund, Sweden.
    The Boston Psychiatric rehabilitation approach – evaluation of an implementation project in Sweden2012In: Programme and Abstract Book, Horatio: 2nd European Festival of Psychiatric Nursing – in Stockholm 2012 / [ed] Patrik Dahlqvist Jönsson, Göteborg: Psykiatriska Riksföreningen för Sjuksköterskor , 2012Conference paper (Refereed)
    Abstract [en]

    Background: Despite the potential impact of psychiatric rehabilitation on wellbeing and health, there is a lack of research regarding the model called Psychiatric Rehabilitation Approach from Boston University. To our knowledge no empirical studies have been made regarding the model in Sweden.

    Aim: The aims of the present study were to investigate outcome of the intervention regarding changes in life situation, use of health care services, quality of life, health, psychosocial functioning and empowerment. Further aims were to investigate to what extent the personal rehabilitation goals were attained and clients’ experiences of the intervention.

    The intervention: Seven mental health services who worked according to the Boston Psychiatric Rehabilitation Approach in the county of Halland in Sweden were included. The purpose of the intervention was to support and guide the patient to formulate and achieve his/her own goals for various life areas such as work/occupation, housing, education and leisure time. All staff working in the chosen services had completed education in the methodology and supervised training in providing the different phases of the rehabilitation process.

    Methods: The study had a prospective longitudinal design and the data collection at baseline started in August 2007 and a 2-year follow-up data collection ended in December 2010. In total 71 patients completed the assessment at baseline and of these 49 completed the 2-year follow-up data collection. Of these 49 clients, a sample of 10 clients was participated in interviews. Statistical analysis and qualitative content analysis were used.

    Results: The result showed a clear indication that Boston Psychiatric Rehabilitation Approach lead to a better life situation with respect to quality of life, health, empowerment and psychosocial functioning as well decreased utilization of psychiatric care. Thirty-two of the clients (65%) considered that they largely or almost completely had achieved their goals. Clients’ experiences of the intervention was summarized in the theme “Recovery ingredients” consisting of three interweaved categories: “Relationship”, “Structure” and “Participation”.

    Conclusion: The clients’ subjective experience of quality of the relationship to the staff do not seem to relate to goal attainment regarding exterior life situation concerning housing situation, work situation, education, leisure time and social relationships but rather between the clients’ goal attainment and other positive results of the rehabilitation as clients’ perceived.

  • 47.
    Jormfeldt, Henrika
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Svensson, Bengt
    Department of Health Sciences, Lund University, Lund, Sweden.
    Hansson, Lars
    Department of Health Sciences, Lund University, Lund, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Clients’ experiences of the Boston Psychiatric Rehabilitation Approach: A qualitative study2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, no 1, article id 22916Article in journal (Refereed)
    Abstract [en]

    The Boston Psychiatric Rehabilitation Approach (PR) has been described as neither being a particular technique nor a single intervention but a service model within the mental health system aiming to promote recovery and the achievement of a meaningful life, rather than simply supporting adaptation or survival in the community. A qualitative approach was used to describe clients’ experiences of a BR implementation project in a county in Sweden. The findings from the interviews could be summarized in the theme “The process of rehabilitation” consisting of three categories: Structure, Participation and Relationship. The results suggest that clients do not often realize nor are able to verbalize their goals before they have been given the possibility to reflect their thoughts in collaboration with a trusted person. It is thus important that PR schedules its special structure to secure client participation by giving the clients opportunity to get their thoughts reflected to be able to participate in decision making regarding their own care. © 2014 H. Jormfeldt et al.

  • 48.
    Jormfeldt, Henrika
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), The Wigforss Group.
    Svensson, Bengt
    Department of Health Sciences, Lund University, Lund, Sweden.
    Hansson, Lars
    Department of Health Sciences, Lund University, Lund, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Relatives’ experiences of the Boston Psychiatric Rehabilitation Approach: A qualitative study2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, no 1, article id 22918Article in journal (Refereed)
    Abstract [en]

    The Boston Psychiatric Rehabilitation approach (BPR) is individualized and characterized by being based entirely on the individual´s unique needs and preferences in the areas of working, learning, social contacts, and living environment. Relatives of clients in mental health services influence the client’s possibilities to recovery by their everyday relationship. Nonetheless traditionally relatives have had a subordinated role in the care of their mentally ill family member. The perspective of relatives is an importance aspect in the development of new approaches to psychiatric rehabilitation. Thus the purpose of the present study was to describe and explore relatives’ experiences of the Boston Psychiatric Rehabilitation Approach. Ten relatives to clients in mental health services approached with the BPR were interviewed. The interviews were transcribed and analyzed with a qualitative content analysis method to explore relatives’ experiences of the BPR intervention in a county of Sweden. The findings from the interviews could be summarized in the theme “To meet the clients’ needs” consisting of three categories: “Dependence in staffs’ competence”, “Responsibility of participation and self-determination” and “The necessity of coordination between authorities and care-givers”.  The findings suggest that relatives may contribute with important information about clients’ needs related to outcome of care. Relatives’ perspectives may be of importance in further development of BPR. Further research about relatives’ role in psychiatric rehabilitation is needed as well as studies comparing different kinds of psychiatric rehabilitation from the perspective of relatives.

  • 49.
    Larsson, Ingrid
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. Spenshult Research and Development Centre, Halmstad, Sweden.
    Fridlund, Bengt
    School of Health and Welfare, Jönköping University, Jönköping, Sweden .
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Teleman, Annika
    Capio Movement Hospital, Halmstad, Sweden.
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention.
    Bergman, Stefan
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health promotion and disease prevention. Spenshult Research and Development Centre, Halmstad, Sweden & University of Gothenburg, Gothenburg, Sweden.
    A nurse-led rheumatology clinic versus rheumatologist-led clinic in monitoring of patients with chronic inflammatory arthritis undergoing biological therapy: a cost comparison study in a randomised controlled trial2015In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 16, article id 354Article in journal (Refereed)
    Abstract [en]

    Background: Recommendations for rheumatology nursing management of chronic inflammatory arthritis (CIA) from European League Against Rheumatism (EULAR) states that nurses should take part in the monitoring patients’ disease and therapy in order to achieve cost savings. The aim of the study was to compare the costs of rheumatology care between a nurse-led rheumatology clinic (NLC), based on person-centred care (PCC), versus a rheumatologist-led clinic (RLC), in monitoring of patients with CIA undergoing biological therapy.

    Methods: Patients with CIA undergoing biological therapy (n = 107) and a Disease Activity Score of 28 ≤ 3.2 were randomised to follow-up by either NLC or RLC. All patients met the rheumatologist at inclusion and after 12 months. In the intervention one of two annual monitoring visits in an RLC was replaced by a visit to an NLC. The primary outcome was total annual cost of rheumatology care.

    Results: A total of 97 patients completed the RCT at the 12 month follow-up. Replacing one of the two annual rheumatologist monitoring visits by a nurse-led monitoring visit, resulted in no additional contacts to the rheumatology clinic, but rather a decrease in the use of resources and a reduction of costs. The total annual rheumatology care costs including fixed monitoring, variable monitoring, rehabilitation, specialist consultations, radiography, and pharmacological therapy, generated €14107.7 per patient in the NLC compared with €16274.9 in the RCL (p = 0.004), giving a €2167.2 (13 %) lower annual cost for the NLC.

    Conclusions: Patients with CIA and low disease activity or in remission undergoing biological therapy can be monitored with a reduced resource use and at a lower annual cost by an NLC, based on PCC with no difference in clinical outcomes. This could free resources for more intensive monitoring of patients early in the disease or patients with high disease activity.

    Trial registration: The trial is registered as a clinical trial at the ClinicalTrials.gov (NCT01071447). Registration date: October 8, 2009.

    © 2015 Larsson et al.

  • 50.
    Larsson, Ingrid
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nyman, Carin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Svedberg, Petra
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Carlsson, Ing-Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Children and young people’s participation in developing interventions in health and well-being: a scoping review2018In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 18, no 507Article, review/survey (Refereed)
    Abstract [en]

    Background: Greater interest is being shown in participatory approaches, especially in research on interventions that concern children and young people'shealth and well-being. Although participatory approaches have user involvement in common, they differ in terms of the explicit guidance on how to actually involve and engage children and young people in health research. The aim of this scoping review was to systematically map recent research involving children and young people in the development of interventions targeting issues of health and well-being. Methods: An interpretative scoping literature review based on: a scientific literature search in (health and social science) databases, reference lists, a manual search in key journals and contact with existing networks was conducted. A total of 4458 references were identified through the literature search, of which 41 studies published between 2000 and 2017 were included in the review. The target population was children and young people under 25 years old. Level of participation was categorized according to Shier's Pathways to Participation Model. Results: The review showed that participatory approaches were most often used in the development of interventions in school settings and in community and healthcare settings and on issues concerning support in lifestyle or in managing illness or disease. The level of participation varied from children and young people taking part just as active informants, through stages of greater participation both in quantitative and qualitative terms, to children and youngpeople becoming an active agent involved as a co-researcher where the research process was shaped by views of a higher level of mutuality. Most of the studies were categorised at a medium level and only three studies were judged to involve the children and young people at the highest level. Conclusions: This scoping review showed that work remains in enabling children and young people to influence the development of interventions targeting health and well-being. In relation to level of sustainability in the interventions, it is relevant that goals, strategies and processes are formulated by those who can gain from the interventions. Participatory approaches aiming for a higher level of participation where children and young people work together with the researchers in partnerships are thus warranted. © 2018 The Author(s).

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