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  • 301.
    Pers, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Nord, Carina
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Svaga flickor och starka pojkar? : En studie om det stöd som ges till unga kvinnor och män som utsätts för våldsbrott2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Socialarbetare kommer dagligen i kontakt med personer som befinner sig i en svår situation livet. En del av dessa människor är unga män och kvinnor som utsatts för brott och som kommer i kontakt med Stödcentrum för unga brottsoffer. Stödcentrum är en verksamhet som finns i ett trettiotal svenska städer och som möter dessa ungdomar. Syftet med denna studie är att undersöka om socialarbetare gör någon skillnad på de insatser som ges beroende på om den hjälpsökande är en ung man eller kvinna. Studien är en totalundersökning som bygger på en sekundäranalys av verksamhetsstatistik. Resultatet visar att oavsett vilket brott den hjälpsökande blivit utsatt för så erhåller unga kvinnor, i jämförelse med män, mer tid och får oftare insatser som innebär känslomässigt stöd. För att förstå dessa skillnader har resultatet analyserats med hjälp av viktimologisk teori, genusteorin samt tidigare forskning på området.

  • 302.
    Persson, Carolina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Norström, Josefine
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Barn och unga med en nära anhörig som avlidit: Barn och ungas erfarenheter av att delta i stödgrupp2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In this qualitative study, questionnaires were collected from children and adolescents who had

    participated in a support group in Dalarnas län for children and adolescents with a deceased

    close relative. The purpose of this study was to enhance knowledge of children and

    adolescents’ experiences of participating in support groups through their descriptions in

    qualitative questionnaires. Qualitative content analysis was conducted and three categories

    were identified; kinship, processing and the significance of structure. The result highlights the

    importance of having the opportunity to meet other children and adolescents in similar

    situations, and indicates that the participants Sense of coherence enhanced through the

    participation in the support group.

  • 303. Petersén, Anna
    et al.
    Lars, Oscarsson
    Kullberg, Christian
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Government, implementation and evaluation: the viability and evaluability of national policy programs2010In: Annual conferens of the American Evaluation Association, San Antonio, Texas, USA, 2010Conference paper (Other academic)
    Abstract [en]

    In many countries, the government is using state subsidies to promote local authorities to improve, e.g., social welfare services. But evaluations of these initiatives often show small effects compared to the politicians´ goals. In the paper we present results from a Swedish study including eight larger national programs aimed at promoting local authorities’ social services. The aim is to analyze and discuss if success or failure to achieve the national goals of the programs can be related to unrealistic political ambitions, to the implementation process, to limitations or deficiencies in the evaluations, or to all three. The first two issues are analysed within a political science model, and in the latter case data availability and evaluation designs are focused. In the light of the results, program theoretical, ethical and qualitative issues in evaluation are discussed.

  • 304.
    Randell, Eva
    Dalarna University, School of Education, Health and Social Studies, Social Work. Umeå Universitet.
    Adolescent boys’ health: managing emotions, masculinities and subjective social status2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The health of adolescent boys is complex and surprisingly little is known about how adolescent boys perceive, conceptualise and experience their health. Thus, the overall aim of this thesis was to explore adolescent boys’ perceptions and experiences of health, emotions, masculinity and subjective social status (SSS).

    This thesis consists of a qualitative, a quantitative and a mixed methods study. The qualitative study aimed to explore how adolescent boys understand the concept of health and what they find important for its achievement. Furthermore, the adolescent boys’ views of masculinity, emotion management and their potential effects on wellbeing were explored. For this purpose, individual interviews were conducted with 33 adolescent boys aged 16-17 years. The quantitative study aimed to investigate the associations between pride, shame and health in adolescence. Data were collected through a cross-sectional postal survey with 705 adolescents. The purpose of the mixed methods study was to investigate associations between SSS in school, socioeconomic status (SES) and self-rated health (SRH), and to explore the concept of SSS in school. Cross-sectional data were combined with interview data in which the meaning of SSS was further explored. Individual interviews with 35 adolescents aged 17-18 years were conducted.

    In the qualitative study, data were analysed using Grounded Theory. In the quantitative study, statistical analyses (e.g., chi-square test and uni- and multivariable logistic regression analyses) were performed. In the mixed method study, a combination of statistical analyses and thematic network analysis was applied.

    The results showed that there was a complexity in how the adolescent boys viewed, experienced, dealt with and valued health. On a conceptual level, they perceived health as holistic but when dealing with difficult emotions, they were prone to separate the body from the mind. Thus, the adolescent boys experienced a difference between health as a concept and health as an experience (paper I). Concerning emotional orientation in masculinity, two main categories of masculine conceptions were identified: a gender-normative masculinity and a non-gender-normative masculinity (paper II). Gender-normative masculinity comprised two seemingly opposite emotional masculinity orientations, one towards toughness and the other towards sensitivity, both of which were highly influenced by contextual and situational group norms and demands, despite that their expressions are in contrast to each other. Non-gender-normative masculinity included an orientation towards sincerity, emphasising the personal values of the boys. Emotions were expressed more independently of peer group norms. The findings suggest that different masculinities and the expression of emotions are intricately intertwined and that managing emotions is vital for wellbeing. The present findings also showed that both shame and pride were significantly associated with SRH, and furthermore, that there seems to be a protective effect of experiencing pride for health (paper III). The results also demonstrated that SSS is strongly related to SRH, and high SRH is related to high SSS, and further that the positioning was done in a gendered space (paper IV).

    Results from all studies suggest that the emotional and relational aspects, as well as perceived SSS, were strongly related to SRH. Positive emotions, trustful relationships and having a sense of belonging were important factors for health and pride was an important emotion protecting health. Physical health, on the other hand, had a more subordinated value, but the body was experienced as an important tool to achieve health. Even though health was mainly perceived in a holistic manner by the boys, there were boys who were prone to dichotomise the health experience into a mind-body dualism when having to deal with difficult emotions.

    In conclusion, this thesis demonstrates that young, masculine health is largely experienced through emotions and relationships between individuals and their contexts affected by gendered practices. Health is to feel and function well in mind and body and to have trusting relationships. The results support theories on health as a social construction of interconnected processes. Having confidence in self-esteem, access to trustful relationships and the courage to resist traditional masculine norms while still reinforcing and maintaining social status are all conducive to good health. Researchers as well as professionals need to consider the complexity of adolescent boys’ health in which norms, values, relationships and gender form its social determinants. Those working with young boys should encourage them to integrate physical, social and emotional aspects of health into an interconnected and holistic experience.

  • 305.
    Randell, Eva
    Dalarna University, School of Education, Health and Social Studies, Social Work. Umeå Universitet.
    Living in the shadow of political decisions: Former refugees’ experiences of supporting newly arrived minors2019Conference paper (Other academic)
    Abstract [en]

    Living in the shadow of political decisions: Former refugees’ experiences of supporting newly arrived minors

    Background and aim: Steady streams of refugees and unaccompanied minors, of which the great majority are boys, come to Sweden, mostly from Afghanistan, Syria and Somalia. Among the arrivals, there are boys with traumatic experiences. It is a challenging task for the society to promote health, empowerment and integration of these minors. With the intention to support their integration in the society, the organisation Save the Children formed special meeting places for unaccompanied minors in 2018 in three municipalities in Sweden. There, the minors had the opportunity to engage in different activities. In addition, psychosocial support was offered. The leaders for the activities at these meeting places were recruited among former refugees who themselves had arrived in Sweden as unaccompanied minors. Research is sparse concerning how foreign-born leaders’ experience how it is to support the integration of the newly arrived minors. Thus, the aim of the study was to explore the perceptions of the meeting place leaders, also former refugees, when supporting newly arrived minors’ integration in society.

    Methods: This is a qualitative study in which interviews were conducted with leaders, also former refugees, at the meeting places for unaccompanied minors in municipalities. Data were analysed using network analysis.

    Results: Based on the preliminary analyses of the interviews, a thematic network was developed. Basic themes were identified, which in turn generated four organising themes and one global theme. The organising themes were ‘integrating together’, ‘keep going’, ‘living in no man’s land’ and ‘being proud helping others’. The four organising themes were then clustered into the global theme of ‘living in the shadow of political decisions’. Although they all expressed a frustration concerning the migration politics, they all perceived the helping role as very important and connected to positive emotions.

    Conclusion and implications: The findings show the massive impact from the national political decisions concerning the right to stay permanently or temporary, which affected the daily lives of the newly arrived at the meeting places and demanded an attitude of never-ending hope in leaders. Despite being forced to deal with difficult emotions - such as despair - the results underscored the important role of feeling proud to help others. Furthermore, the own experiences of being a refugee were valued and shared in meeting the unaccompanied minors. The integration process is generally complex, and further studies of what is helpful in the integration process are needed.

  • 306.
    Randell, Eva
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Janeslätt, Gunnel
    Department of Public Health and Caring Sciences, Disability and Habilitation, Uppsala University, SUF Resource center, Uppsala, Center for Clinical Research in Dalarna .
    Höglund, Berit
    Department of Women's and Children's Health, International Sexual and Reproductive Health, Akademiska Hospital, Sweden.
    How can an intervention with knowledge and care-taking prepare youth with ID for future decisions to parenthood?2019In: IASSID 2019, The world congress of the international association for the scientific study of intellectual and developmental disabilities, 2019, Glasgow, Scottland, 2019Conference paper (Other academic)
    Abstract [en]

    Introduction

    There is limited knowledge about how young people with intellectual disability (ID) can be facilitated in their process of deciding about parenthood in future. This study aimed to explore an intervention using the Toolkit “Children – what does it involve? and the “Real Care Baby” (RCB) simulator among pupils with ID.

    Methods

    Pupils (n=15) with ID participated in an intervention with 12 educational sessions and a three-day caring session with the RCB simulator. Data were collected with individual in-depth interviews. Content analysis was used.

    Results

    Preliminary results showed that the intervention gave knowledge and experiences, which promoted insights in parenthood among these pupils. They described both basic and more specific needs of the child and the complexity of caring a child and being a responsible parent. Parent´s relationship was emphasised as well as to be an autonomously adult. Final results are pending.

    Implications

    By receiving adapted knowledge and experiences, pupils with ID became more suited to make informed decisions about parenthood in future.

  • 307.
    Randell, Eva
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Jerdén, L.
    Öhman, A.
    Flacking, Renée
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    What is health and what is important for its achievement?: A qualitative study on adolescent boys’ perceptions and experiences of health2016In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 10, p. 26-35Article in journal (Refereed)
    Abstract [en]

    Few qualitative studies have explored adolescent boys’ perceptions of health.

    Aim: The aim of this study was therefore to explore how adolescent boys understand the concept of health and what they find important for its achievement

    Methods: Grounded theory was used as a method to analyse interviews with 33 adolescent boys aged 16 to 17 years attending three upper secondary schools in a relatively small town in Sweden.

    Results: There was a complexity in how health was perceived, experienced, dealt with, and valued. Although health on a conceptual level was described as ‘holistic’, health was experienced and dealt with in a more dualistic manner, one in which the boys were prone to differentiate between mind and body. Health was experienced as mainly emotional and relational, whereas the body had a subordinate value. The presence of positive emotions, experiencing self-esteem, balance in life, trustful relationships, and having a sense of belonging were important factors for health while the body was experienced as a tool to achieve health, as energy, and as a condition.

    Conclusion: Our findings indicate that young, masculine health is largely experienced through emotions and relationships and thus support theories on health as a social construction of interconnected processes. 

  • 308.
    Randell, Eva
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Jerdén, Lars
    Öhman, Ann
    Starrin, Bengt
    Flacking, Renée
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Tough, sensitive and sincere: how adolescent boys manage masculinities and emotions2015In: International Journal of Adolescence and Youth, ISSN 0267-3843, E-ISSN 2164-4527, Vol. 21, no 4, p. 486-498Article in journal (Refereed)
    Abstract [en]

    This study aimed to explore adolescent boys’ views of masculinity and emotion management and their potential effects on well-being. Interviews with 33 adolescent boys aged 16–17 years in Sweden were analysed using grounded theory. We found two main categories of masculine conceptions in adolescent boys: gender-normative masculinity with emphasis on group-based values, and non-gender-normative masculinity based on personal values. Gender-normative masculinity comprised two seemingly opposite emotional masculinity orientations, one towards toughness and the other towards sensitivity, both of which were highly influenced by contextual and situational group norms and demands, despite their expressions contrasting each other. Non-gender-normative masculinity included an orientation towards sincerity emphasising the personal values of the boys; emotions were expressed more independently of peer group norms. Our findings suggest that different masculinities and the expression of emotions are strongly intertwined and that managing emotions is vital for well-being.

  • 309.
    Randell, Eva
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work. Umeå Universitet.
    joffer, Junia
    Flacking, Renée
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Starrin, Bengt
    Jerdén, Lars
    Associations between pride, shame and self-rated health in adolescence2016Conference paper (Other academic)
  • 310.
    Randell, Eva
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work. Umeå Universitet.
    Joffer, Junia
    Flacking, Renée
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Starrin, Bengt
    Jerdén, Lars
    Umeå universitet; Uppsala universitet.
    Pride, shame and health among adolescents – a cross-sectional survey2018In: International Journal of Adolescent Medicine and Health, ISSN 0334-0139, E-ISSN 2191-0278, Vol. 30, no 6, article id 20160107Article in journal (Refereed)
    Abstract [en]

    Background

    Pride and shame are important emotions known to influence identity development and psychological well-being in adolescence. Research evidence indicates that self-rated health (SRH) is a strong predictor of future health. This cross-sectional study, conducted during 2008–2009, aimed to investigate the associations between pride, shame and SRH among adolescent boys and girls.

    Methods

    The study sample comprised 705 adolescents in Sweden aged 17–18 years (318 boys and 387 girls) who completed a questionnaire that included items on SRH, shame and pride (participation rate 67%). Logistic regression analyses (univariable and multivariable) were used to investigate the associations between pride and shame as separate and combined constructs on SRH, adjusting for potential confounders (country of birth, parental educational level, school experience, having enough friends, mood in family and being active in associations).

    Results

    Pride and shame separately were significantly associated with SRH in both genders. Logistic regression analysis of the pride-shame model showed that the odds of having lower SRH were highest in boys and girls with lower pride-higher shame. In a multivariable logistic regression analysis of the pride-shame model the odds of having lower SRH remained significant in boys and girls with lower pride-higher shame [boys: odds ratio (OR) 3.51, confidence interval (CI) 1.40–8.81; girls: OR 2.70, CI 1.22–5.96] and in girls with lower pride-lower shame (OR 2.16, CI 1.02–4.56).

    Conclusion

    The emotions of shame and pride are associated with SRH in adolescence. Experiencing pride seems to serve as a protective mechanism in SRH in adolescents exposed to shame. We believe that this knowledge should be useful in adolescent health promotion.

  • 311.
    Ronnheim, Fredrik
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Persson, Christoffer
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Sjukhuskuratorers erfarenheter av sympatistress: Inom den somatiska sektionen av hälso- och sjukvård2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study was to investigate hospital social workers experiences of compassion fatigue as well as examine how they feel and think about their work situation based on KASAM. The purpose was also to understand the hospital social workers experiences of compassion fatigue in relation to the hospital social workers feelings and thoughts about their work situation based on KASAM. The method that was used is a qualitative interview in which six hospital social workers were separately interviewed.

    The study showed that several hospital social workers have experiences of compassion fatigue. The study also showed several indications that there were work situations where hospital social workers had some difficulties in feeling manageability, comprehensibility and meaningfulness. It also showed several indications that there were work situations where hospital social workers felt manageability, comprehensibility and meaningfulness.

    The study concluded that the hospital social workers are exposed to situations in their work that can lead to the development of symptoms for compassion fatigue.

  • 312.
    Roos, Stina
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Barnhemsplacerade barn i Ghana: Betydelsen av personalens bemötande2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study was to create knowledge and obtain an understanding of the importance of the staff’s attitude and their way of meeting the emotional needs of the children who were living at the orphanage. The study also aimed to investigate how and to what extent the children receive help from the staff to achieve self-fulfillment and reach their dreams.

    Qualitative method was used and four individual (semi-structured) interviews were conducted. The analysis was done based on previous research in the area and Maslows hierarchy of needs. The result shows that the staff believes it is of great importance that there should be someone who listens to the children. If there is someone who listens to the children, they get a chance to process any traumatic events they might have experienced and develop hope of reaching their dreams.

    The conclusion of the study is that the attitude of the staff is very important for the children's well-being and development.

  • 313.
    Rosenberg, David
    et al.
    Umeå universitet, Institutionen för socialt arbete.
    Schön, Ulla-Karin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Återhämtning: Från idé till praktik2014In: Att leva med psykisk funktionsnedsättning: Livssituation och effektiva vård- och stödinsats / [ed] David Brunt och Lars Hansson, Lund: Studentlitteratur , 2014, 2Chapter in book (Other academic)
  • 314. Rosenberg, David
    et al.
    Schön, Ulla-Karin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Nyholm, Maria
    Grim, Katarina
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Svedberg, Petra
    Shared decision making in Swedish community mental health services - an evaluation of three self-reporting instruments.2017In: Journal of Mental Health, ISSN 0963-8237, E-ISSN 1360-0567, Vol. 26, no 2, p. 142-149Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Despite the potential impact of shared decision making on users satisfaction with care and quality in health care decisions, there is a lack of knowledge and skills regarding how to work with shared decision making among health care providers.

    AIM: The aim of this study was to evaluate the psychometric properties of three instruments that measure varied dimensions of shared decision making, based on self-reports by clients, in a Swedish community mental health context.

    METHOD: The study sample consisted of 121 clients with experience of community mental health care, and involved in a wide range of decisions regarding both social support and treatment. The questionnaires were examined for face and content validity, internal consistency, test-retest reliability and construct validity.

    RESULTS: The instruments displayed good face and content validity, satisfactory internal consistency and a moderate to good level of stability in test-retest reliability with fair to moderate construct correlations, in a sample of clients with serious mental illness and experience of community mental health services in Sweden.

    CONCLUSIONS: The questionnaires are considered to be relevant to the decision making process, user-friendly and appropriate in a Swedish community mental health care context. They functioned well in settings where non-medical decisions, regarding social and support services, are the primary focus. The use of instruments that measure various dimensions of the self-reported experience of clients, can be a key factor in developing knowledge of how best to implement shared decision making in mental health services.

  • 315. Rosenberg, David
    et al.
    Svedberg, Petra
    Schön, Ulla-Karin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Establishing a recovery orientation in mental health services: Evaluating the Recovery Self-Assessment (RSA) in a Swedish context2015In: Psychiatric rehabilitation journal, ISSN 1095-158X, E-ISSN 1559-3126, Vol. 38, no 4, p. 328-335Article in journal (Refereed)
    Abstract [en]

    Objective: Although there has been an emphasis on developing knowledge regarding recovery in Sweden, it is unclear to what extent this has been translated into a recovery orientation in the provision of mental health services. Instruments, which present the components of recovery as measurable dimensions of change, may provide a framework for program development. Involving users is an essential factor in the utilization of such tools. The purpose of this study was to evaluate the psychometric properties of the Recovery Self-Assessment (RSA) measure and its potential for being utilized in a Swedish context. Methods: The sample consisted of 78 participants from 6 community mental health services targeting people with serious mental illnesses in a municipality in Sweden. They completed the RSA at the study baseline and two weeks later. User panels participated in the translation and administration of the RSA and the reporting of results. Results: The Swedish version of the RSA had good face and content validity, satisfactory internal consistency, and a moderate to good level of stability in test-retest reliability. The user panels contributed to establishing validity and as collaborators in the study. Conclusions and Implications for Practice: Establishing the RSA as a valid and reliable instrument with which to focus on the recovery orientation of services is a first step in beginning to study the types of interventions that may effect and contribute to recovery oriented practice in Sweden. © 2015 American Psychological Association.

  • 316.
    Rubin, Liselotte
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Skolkuratorns roll i arbetet mot mobbning: En kvalitativ studie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study was to examine how school counselors experienced their work against bullying and how they actually work against bullying. The study was qualitative based on interviews with seven school counselors at different schools in two smaller municipalities.

    The results of the study showed that school counselors want to work more with the prevention of bullying than time allows. Their work is more about to go in and help where need and bullying problems already exist. There are no recommended programs and methods concerning how to combat bullying, so it is up to the school counselors to improvise and use a method to suit the individual student. There is a need to develop a program and method concept that corresponds to today’s problems.

  • 317.
    Rydström, Julia
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Mångs Tengström, Magdalena
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Kunskap om kultur – ett bidrag till en ökad medvetenhet om sig själv och andra: Socialsekreterares syn på betydelsen av kunskap om kultur i socialt arbete2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study is to examine how social workers look at the importance of

    knowledge of culture in social work. A qualitative interview study was used in which five social workers were interviewed. The results were then analyzed based on previous research and culture as a theoretical framework. The study shows that social workers believe that knowledge of culture is of great importance in their practical social work. Knowledge of culture was seen as a contribute to a further understanding of different circumstances of the clients. Social workers were found to have different views on the extent of their knowledge

    of culture as some felt that their knowledge is sufficient to be able to perform good social

    work, while others thought that they are in need of more knowledge. The social workers own

    culture were seen by some as an important part in meeting with clients, while others were

    not at all aware of their own culture and its influence on their work.

  • 318.
    Samuelsson, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Sjödin, Viktoria
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Från ord till handling: En kvalitativ studie om värdegrund och socialt innehåll för äldre på särskilt boende2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Research shows that many nursing home residents are disappointed with their level of social interaction and activity. Care of older people is argued to be underpinned by national core values such as supporting dignity and well-being, but it is not clear how such values influence nursing home staff practices or the social activities provided. Our study addressed this question.

    Five nursing homes, representing both private and public care providers, were sampled from two different municipalities. Semi-structured interviews were carried out with the homes’ respective heads of unit, transcribed, and thematically analysed.

    Our results indicate that the national values for care of older people were interpreted uniquely within each home. All heads of units emphasised the importance of person-centred care, yet similar social activities were offered by all homes, with a focus on group activities. We discuss our results with reference to activity theory and gerotranscendence.

  • 319.
    Sanchez, Denise
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Fogelquist Hedwall, Linda
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Arbetet för en ökad KASAM och integrering.: En kvalitativ studie om ett utbildnings- och aktiveringsprograms utformning av aktiviteter.2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Our purpose with the study was to investigate in what way the personal at a municipal education- and activity program worked to increase the three components; comprehensibility, manageability and meaningfulness in the participants sense of coherence (SOC). The method used was a qualitative interview study in which the personal at an education- and activity program was interviewed.

    The collected material was processed by a theoretical thematic analysis. By analyzing the result, six sub-themes were crystallized, with a starting point from our three predefined main themes were: comprehensibility, meaningfulness and manageability. The result showed that the staff for example worked with teaching language, motivational work and practical training. The staff stated that teaching language contributed to the participants sense of comprehensibility, motivational work contributed to a sense of meaningfulness and practical training contributed to a sense of manageability. The study showed that the program worked to increase all three components in the participants SOC, but the staff wished to work even more with the parts that increase the sense of meaningfulness.

  • 320.
    Sandbäck, Evelina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Selin, Jonna
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    "Det väcker fler etiska funderingar när det gäller äldre personer": En kvalitativ studie om socialsekreterares upplevelser kring den etiska synen på äldre med alkoholmissbruk2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of the study was to investigate how social workers looked at the possibility that their ethical view of elderly with alcohol abuse affects their assessments. We used semi structured interview, where we interviewed six social workers that works with addiction. The result showed that the social workers felt that the biggest difference between people over and under the age of 65 was the needs, which meant that the assessments of contribution differed. The result showed that the social workers resonated very much about LVM, since coercion in relation to older people created many ethical dilemmas. The personal values of the social workers did not affect the assessment themselves, but they were always there, both in private and working life. In order to avoid their own values affecting their assessments, this was frequently discussed between colleagues. The result showed that ageism is both in structure and jargon, but that there was no opportunity for ageism to influence the social security assessments.

  • 321.
    Schön, Ulla-Karin
    Dalarna University, School of Health and Social Studies, Social Work.
    Brukarmedverkan i en evidensbaserad praktik2012Conference paper (Refereed)
    Abstract [sv]

    Bakgrund

    När det gäller stöd och service till människor med psykisk ohälsa finns idag en förhållandevis god kunskap om människors möjligheter till återhämtning från allvarliga psykiska besvär (Schön, 2009; Slade 2011; Topor 2004). Faktorer som brukarmedverkan, kontinuitet, sociala relationer är några av de faktorer som identifieras som grundläggande i en återhämtningsprocess (a.a). Fortfarande är dock brukarmedverkan i socialtjänsten en begränsad praktik och relativt outforskat. Trots att det på senare år allt mer påtalats att socialtjänstens praktik behöver bli en ”evidensbaserad” praktik är användandet av brukarkunskap i socialtjänstens en saknad del i en sådan kunskapsutveckling (McLaughlin, 2011). En evidensbaserad praktik definieras ofta som att bestå av ”tre ben” bästa tillgängliga kunskap, de professionella samt brukarnas kunskaper och önskemål. Brukarmedverkan i denna process innebär att brukare och deras närstående inte bara ses som aktörer i en politisk process, utan också som en omistlig kunskapskälla med erfarenheter och perspektiv viktiga för en bred kunskapsbildning (Socialstyrelsen 2005).

    Argument och fokus för brukarmedverkan kan relateras till tre områden, nämligen frågor relaterade till demokrati (Dahlberg & Vedung, 2001), frågor relaterade till makt och egenmakt (Beresford et al, 2008; Beresford 2010) samt frågor relaterade till tjänsters utveckling (Barnes et al 2000), där utvecklingen av en evidensbaserad social service ingår. Vissa forskare menar att socialtjänstens utveckling, i likhet med andra områden såsom t ex vård och omsorg, under senare år har präglats av en stark individualisering och valfrihets ambition utifrån en top-down perspektiv, vilket anses ha överskuggat den demokratiska eller "bottom-up"-strategi som är mer kritisk och främjande av social förändring och social rättvisa (Beresford 2010; Ferguson, 2008). I Storbritannien t ex har t ex brukarmedverkan setts som framgångsrikt om deltagande har varit framgångsrik i motsats till att fokusera på resultat eller effekt av detta deltagande för t ex utvecklingen av tjänster eller forskning (Carr 2004; McLaughlin, 2009).

    Syfte

    Syftet med detta projekt är att studera och utveckla kunskapsområdet brukarmedverkan i socialtjänstens praktik. Detta ska ske genom en kunskapsöversikt av betydelsen av brukarmedverkan i socialtjänstens praktik. Ett annat syfte är att pröva om, och i så fall hur, brukarkunskap påverkar kunskapsområdet genom att göra erfarenhetsbaserad kunskap tillgänglig för lärande för studenter, yrkesverksamma och för forskare inom socialt arbete. Ett ytterligare syfte är att undersöka vad brukarmedverkan i en sådan erfarenhetspanel kan innebära för enskildas återhämtningsprocesser från psykisk ohälsa. 

  • 322.
    Schön, Ulla-Karin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Can gender sensitivity in psychiatry improve recovery?2012Conference paper (Refereed)
    Abstract [en]

    Introduction: In recent years research on recovery have resulted in new knowledge and gained relevance in the mental health field. Still recovery is discussed in terms of individual journeys to find ways to live a hopeful and satisfying life. Taking the concept of gender into consideration it is possible to begin to address additional questions about how women and men influence their recovery; how they perceive and understand the society in which they live, and how they are likely to be regarded and treated within that society.

    Methods: In a study conducted in Sweden 30 first-person accounts of recovery from mental illness were examined. The study was undertaken to determine if there was gender diversity in what people described as being decisive factors for their recovery.

    Results: The results illustrates a gender advantage for the men in their ability to make use of the psychiatric services offered in their coping strategies mainly focusing on remission, education and control over symptoms. The women, on the other hand, described hospitalization and psychiatric medication more in terms of coercion and helplessness. These results may raise the need for a gender perspective in psychiatry to reduce the female impediment to access to safe and effective psychiatric care. But the results also illustrate how gender norms, outside psychiatry, benefit women more than men in a recovery perspective. In spite of structural gender inequalities, female gender norms seemed to be an advantage in the recovery process. The female recovery process was focused on making sense and meaning, whereas the male recovery process was focused on reinforcement of traditional roles such as occupation and independence. The women also had a higher capacity to receive and maintain support from their social networks than did the men.

  • 323.
    Schön, Ulla-Karin
    Dalarna University, School of Health and Social Studies, Social Work.
    Kunskapsbaserad praktik och brukarmedverkan för att stödja människors återhämtning från psykisk ohälsa2011In: Hälsa, Livskvalitet och Välfärd. Forskningskonferens, Falun, 2011Conference paper (Other academic)
    Abstract [sv]

    Bakgrund Behovet av en evidensbaserad praktik påtalas allt mer. Det handlar bland annat om ett behov av att implementera ny kunskap, att systematiserat följa upp de insatser som ges, och i högre utsträckning inkludera brukaren i insatsernas utformning. I dag är kunskapen fortfarande begränsad kring betydelsen av brukarmedverkan både för verksamhetsutveckling och för den enskildes livskvalitet och upplevelse av tjänsterna. När det gäller stöd och service till människor med psykisk ohälsa har faktorer som brukarmedverkan, kontinuitet, sociala relationer identifierats som grundläggande i återhämtningsforskningen. Men denna kunskap har i mycket begränsad omfattning fått implikationer på politik och praktik. Det saknas metoder och system för en evidensbaserad psykiatri och socialtjänst till stöd för människors återhämtning från psykisk ohälsa. Syfte Projektet ska studera former för brukarmedverkan i en kunskapsbaserad praktik. Den centrala forskningsfrågan handlar sålunda om brukarmedverkan kan bidra till verksamhetsutveckling och förbättra den enskildes livskvalitet och upplevelse av tjänsterna. Om systematiserade mätningar av brukarupplevelse påverkar de insatser som ges till människor med psykisk ohälsa, med speciellt fokus på samspelet mellan individens erfarenhetskunskap och personalens bemötande och verksamheters utbud. Projektets syfte och forskningsfråga rymmer även ett återhämtningsperspektiv i vilket ovanstående frågor studeras utifrån grundantagandet att en ökad brukarmedverkan bidrar till ökade möjligheter till återhämtning. I projektet planeras tre delstudier, var och en med sin speciella fokusering när det gäller kunskap, implikationer för praktiken och individers möjligheter till återhämtning. Metod Delstudie 1 är en kvalitativ litteraturstudie. Delstudie 2 har en explorativ ansats där en erfarenhetspanel planeras samt brukarerfarna forskningspartners. Fokusgruppsintervjuer samt individuella intervjuer kommer att genomföras. Delstudie 3 är en kvantitativ studie där en validerad skattningsskala, Inspire 3.0, kommer att användas.

  • 324.
    Schön, Ulla-Karin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Psychosocial interventions; collaboration and shared decision-making?: A participatory research project to develop and implement shared decision-making in psychiatric services2015Conference paper (Refereed)
  • 325.
    Schön, Ulla-Karin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Recovery in involuntary psychiatric care: is there a gender difference?2013In: Journal of Mental Health, ISSN 0963-8237, E-ISSN 1360-0567, Vol. 22, no 5, p. 420-427Article in journal (Refereed)
    Abstract [en]

    Background: Research on recovery from mental illness and the influence of compulsory psychiatric institutional care has revealed the complexity of this concept. There is also limited knowledge regarding the impact of gender-role expectations in these contexts, and how such expectations may influence both the care and individuals’ recovery processes.

    Aim: To explore women’s and men’s perceptions of the impact of compulsory inpatient care on recovery from severe mental illness.

    Method: Grounded theory was used to analyse 30 first-person accounts of recovery from mental illness, elicited via interviews with individuals who had been compulsorily treated in hospital and diagnosed with a severe mental illness.

    Results: Inpatient care at an early stage was crucial for the informants’ recovery. However, there was ambivalence in their perceptions of the impact of compulsory inpatient care. The narratives confirmed gender differences as well as gender stereotypes.

    Conclusions: The results have implications for recovery research, in that they emphasise the importance of understanding recovery as a gender-influenced process.

  • 326.
    Schön, Ulla-Karin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    User and carer involvement in social work education: reasons for participation2016In: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 18, no 2, p. 154-163Article in journal (Refereed)
    Abstract [en]

    In many countries, user involvement in social work (SW) education is common practice, while in other countries, initiatives for inclusion are currently expanding. No matter how far the progress of user involvement in education has come, issues on clarity, sustainability and accountability need to be addressed. In this paper, users’ reasons for wanting to participate in SW education and the way they define their potential contribution are explored. These experiences can provide important information contributing to sustainable, meaningful, and accountable collaborations between users, university staff and students. Participants (n = 33) answered a questionnaire including demographic data and four open-ended questions about their expectations of participation in a SW programme at the University of Dalarna in Sweden. The results from the open-ended questions were analysed using qualitative content analysis. Results show that users’ main reasons for wanting to get involved were to contribute through sharing their lived experience of SW education, to help improve services and also to obtain respect for their own personal knowledge and experience. The respondents described themselves both as carriers of valuable knowledge and as accountable experts on the subject.

  • 327.
    Schön, Ulla-Karin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    User involvement in social work and education: a matter of participation?2016In: Journal of Evidence-Informed Social Work, ISSN 2376-1407, E-ISSN 2376-1415, Vol. 13, no 1, p. 21-33Article in journal (Refereed)
    Abstract [en]

    The increase in user involvement in social work practice and education can be explained by incentives toward an evidence-based practice, such as those offered by legislation and from the user movement, and those related to professional development. Still, the clients' involvement in research and practice is highlighted as a gap that needs to be filled. The aim of the author in this article is to study the presence of user involvement in social work practice, research, and education, and the level of influence of users and carers within these activities. The results reflect an expanding user involvement in social work practice. Still, projects of user involvement in social work practice are often developed on an ad hoc and inconsistent basis, and knowledge about the effects of these efforts is still limited. User involvement is not to be understood as something that is self-evidently good. On the contrary, the results present a rather complex concept that is bound up with changing and contested understandings of the role of the social worker, academia, and the users themselves.

  • 328.
    Schön, Ulla-Karin
    Dalarna University, School of Health and Social Studies, Social Work.
    Vad avses med återhämtning från psykisk ohälsa?2012In: Rehabilitering och stöd till återhämtning vid psykiska funktionshinder: möjlighetens metoder för en ny praktik / [ed] Ershammar, David; Bogarve, Camilla; Rosenberg, David, Stockholm: Gothia förlag , 2012Chapter in book (Other academic)
  • 329.
    Schön, Ulla-Karin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Grim, Katarina
    Dalarna University, School of Education, Health and Social Studies, Caring Science. Karlstad universitet.
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Psychiatric service staff perceptions of implementing a shared decision-making tool: A process evaluation study2018In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 13, no 1Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    Shared decision making, SDM, in psychiatric services, supports users to experience a greater sense of involvement in treatment, self-efficacy, autonomy and reduced coercion. Decision tools adapted to the needs of users have the potential to support SDM and restructure how users and staff work together to arrive at shared decisions. The aim of this study was to describe and analyse the implementation process of an SDM intervention for users of psychiatric services in Sweden.

    METHOD:

    The implementation was studied through a process evaluation utilizing both quantitative and qualitative methods. In designing the process evaluation for the intervention, three evaluation components were emphasized: contextual factors, implementation issues and mechanisms of impact.

    RESULTS:

    The study addresses critical implementation issues related to decision-making authority, the perceived decision-making ability of users and the readiness of the service to increase influence and participation. It also emphasizes the importance of facilitation, as well as suggesting contextual adaptations that may be relevant for the local organizations.

    CONCLUSION:

    The results indicate that staff perceived the decision support tool as user-friendly and useful in supporting participation in decision-making, and suggest that such concrete supports to participation can be a factor in implementation if adequate attention is paid to organizational contexts and structures.

  • 330.
    Schön, Ulla-Karin
    et al.
    Dalarna University, School of Health and Social Studies, Social Work.
    Rosenberg, David
    Umeå universitet.
    Transplanting Recovery? Research and practice in the Nordic countries2013In: Tenth International Conference of the European Network For Mental Health Service Evaluation: Abstract book, 2013, p. 205-205Conference paper (Refereed)
    Abstract [en]

    Background/ObjectivesThe conceptual framework which describes recovery from mental illness is based primarily on studies conducted in English-speaking countries. Knowledge and development of a recovery orientation within other cultures and mental health systems is still limited, and few studies have discussed the impact of varied national contexts on the development and implementation of recovery-oriented services. The aim of this study was to compile, describe and discuss the research on personal recovery and recovery oriented practice within the psychiatric and social fields in the Nordic countries. MethodsA systematic literature review of Nordic research on recovery from mental illness was conducted which included studies that clearly focused on Recovery as a knowledge base in psychiatric and social services.ResultsTwenty one studies were reviewed, summarized and analyzed with regard to their findings regarding the recovery process, descriptions of interventions which promote recovery and factors which might be specific to the Nordic context and mental health system. The majority of the studies were qualitative and stressed the importance of social relations, environmental factors and peer support. The identified research literature was limited and primarily replicated designs and confirmed findings first presented in North American and British studies. Few studies referred to aspects of welfare system, mental health service structures or cultural factors that might impact the recovery process.Discussion/ConclusionThere is a need to identify and describe factors in Nordic mental health systems that may influence the recovery process. If research does not attend to cultural and organizational differences that may impact the development and implementation of recovery services there is a risk that users will not gain access to these interventions in a manner relevant to their needs. A corresponding challenge will be to translate and further develop outcome indicators that can promote a recovery oriented health system.

  • 331.
    Schön, Ulla-Karin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Rosenberg, David
    Department of Social Work, Umeå University, Umeå, Sweden .
    Transplanting recovery?: Research and practice in the Nordic countries2013In: Journal of Mental Health, ISSN 0963-8237, E-ISSN 1360-0567, Vol. 22, no 6, p. 563-569Article in journal (Refereed)
    Abstract [en]

    Background: The conceptual framework which describes recovery from mental illness is based primarily on studies conducted in English-speaking countries. Knowledge and development of recovery orientation within other cultures and mental health systems is still limited.

    Aim: The aim of this study was to compile, describe, and discuss the research on personal recovery and recovery-oriented practice within the psychiatric and social fields in the Nordic countries.   

    Method: A systematic literature review of Nordic research on recovery from mental illness.

     

    Results: The research literature is limited, and primarily replicates designs and confirms findings first presented in studies conducted in the USA and Great Britain.

    The majority of the studies are qualitative, and point to the importance of social relations, environmental factors, and peer support.

     

    Conclusions: There is a need to identify and describe factors in Nordic mental health systems that may influence the recovery process. A corresponding challenge will be to translate and further develop outcome indicators that can promote a recovery-oriented health system.

  • 332.
    Schön, Ulla-Karin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Svedberg, Petra
    Högskolan i Halmstad.
    Rosenberg, David
    Umeå Universitet.
    Evaluating the INSPIRE measure of staff support for personal recovery in a Swedish psychiatric context2015In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 69, no 4, p. 275-281Article in journal (Refereed)
    Abstract [en]

    Background: Recovery is understood as an individual process that cannot be controlled, but can be supported and facilitated at the individual, organizational and system levels. Standardised measures of recovery may play a critical role in contributing to the development of a recovery-oriented system. The INSPIRE measure is a 28-item service user-rated measure of recovery support. INSPIRE assesses both the individual preferences of the user in the recovery process and their experience of support from staff.

    Aim: The aim of this study was to evaluate the psychometric properties of the Swedish version of the INSPIRE measure, for potential use in Swedish mental health services  and in  order to promote recovery in mental illness.

    Method: The sample consisted of 85 participants from 6 community mental health services targeting people with a diagnosis of psychosis in a municipality in Sweden. For the test-retest evaluation 78 participants completed the questionnaire two weeks later.   

    Results: The results in the present study indicate that the Swedish version of the INSPIRE measure had good face and content validity, satisfactory internal consistency and some level of instability in test-retest reliability.

    Conclusions: While further studies that test the instrument in a larger and more diverse clinical context are needed, INSPIRE can be considered as a relevant and feasible instrument to utilize in supporting the development of a recovery-oriented system in Sweden.

  • 333.
    Sinisalo, Johanna
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    NÄR HUSSE SLÅR: En kvalitativ undersökning om socialtjänstens förutsättningar att inkludera sällskapsdjur i arbetet med våld i nära relation2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    There is a link between violence against animals and domestic violence. Research

    emphasizes the importance of professionals possessing knowledge about the link as

    part of preventing, identifying and counteracting domestic violence. The purpose of

    this paper was to examine the social services' organizational conditions in adopting a

    pet-inclusive approach in the work with domestic violence. With references to the

    human-animal bond and the theory of social support, I emphasized the gain found in

    an approach of this kind. As method for data collection, semi-structured interviews

    were held with six social workers active in the field of domestic violence, from six

    municipalities in the middle parts of Sweden. Qualitative content analysis was then

    conducted, and the results indicate that although some social workers strive to include

    animals, animals generally have low priority on the social services agenda. A more

    consistent and effective provision of support could be achieved through national

    guidelines.

  • 334. Skillmark, Mikael
    et al.
    Kullberg, Christian
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Fäldt, Johannes
    Balancing on the continuum between perpetrator and victim: Social workers understandings of men as victims of violence2011In: Joint Nordic Conference on Welfare and professionalism in Turbulent Times, Reykjavik, 2011Conference paper (Refereed)
  • 335.
    Stenvall, Johanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Örnlind, Maria
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Den individuella återhämtningsprocessen från missbruk och kriminalitet: En kvalitativ studie av aktuella självbiografier2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Recovery is an individual process about creating hope, meaning and identity.

    Significant is access to supportive relationships and networks. This approach

    permeates and is the starting point for this study. The aim is to study the

    individual's recovery from abuse and crime.

    The recovery process was studied on the basis of seven current

    autobiographies, analyzed through thematic analysis, and linked to previous

    research and the theory The four columns of the individual recovery process. The

    columns includes redefinition of itself, the importance of support, dealing with

    symptoms and involvement in meaningful activity.

    The results show, in addition to the theory, that it is important for the

    autobiographer’s recovery to perform symbolic actions to show that a change has

    begun, and to end non-supporting relationships. The study shows that the

    autobiographer’s recovery from abuse and crime can be considered as a single

    process.

  • 336.
    Sundberg, Jenny
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Svensson, Emma
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Att hantera sin förälders missbruk: En kvalitativ intervjustudie om socialarbetares förståelse av copingstrategier hos barn till missbrukande föräldrar2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of the study is to investigate the coping strategies that children use when dealing with their parents' addiction. A qualitative approach and method was used to answer the purpose. The collection of data was acquired through qualitative semi-structured interviews with six social workers with professional experience of meeting children with addicted parents. The material was thematically analyzed and then the theory of coping by Lazarus and Folkman (1984) was applied on the results. The conclusion of the study is that the children have different types of coping strategies when dealing with their parents' abuse. The coping strategies differ based on age and gender of the children.

  • 337. Svenningsson, I
    et al.
    Petersson, E-L
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Westman, J
    Björkelund, C
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Center for Clinical Research; Karolinska institutet, Göteborgs universitet.
    Process evaluation of a cluster randomised intervention in Swedish primary care: using care managers in collaborative care to improve care quality for patients with depression.2019In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 20, no 1, article id 108Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The collaborative care model with a care manager has previously generated beneficial results for patients with depression in terms of decreased burden of depression symptoms. A care manager function has been tested in Sweden in the PRIM-CARE RCT with successful results. The aim of the present study was to evaluate the process of implementing care managers in collaborative care for patients with depression in Swedish primary health care in the PRIM-CARE RCT.

    METHODS: The study followed UK Medical Research Council guidance for process evaluation. Field notes from the implementation of the PRIM - CARE RCT were used, as well as data collected from five focus group discussions with General Practitioners (n = 29) and three focus group discussions with care managers (n = 11). Data were analysed with content analysis.

    RESULTS: Training sessions, careful preparation and extensive initial support to the care manager and staff at the Primary Care Centres were important ingredients in the implementation. The close access to facilitators, the recurrent peer support meetings, and the weekly newsletter strengthened the care manager function.

    CONCLUSIONS: A complex intervention adapted to the Swedish primary care context focusing on a care manager function for patients with depression could be performed through a stepwise implementation process. Financial support from the health care regions included in the study helped to reduce the impact of identified barriers. This process evaluation has revealed new and important knowledge for primary care development concerning infrastructure and organization building, knowledge sharing, and facilitating factors and barriers.

    TRIAL REGISTRATION: NCT02378272 Care Manager - Coordinating Care for Person Centered Management of Depression in Primary Care (PRIM - CARE). Registered March 4 2015. Retrospectively registered.

  • 338.
    Svenningsson, Irene
    et al.
    Sahlgrenska Akademin, Göteborgs universitet.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Westman, Jeanette
    Nejati, Shabnam
    Hange, Dominique
    Björkelund, Cecilia
    Petersson, Eva-Lisa
    Creating a safety net for patients with depression inprimary care: a qualitative study of care managers’ experiences2018In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 36, no 4, p. 355-362Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to explore nurses’experiences and perceptions of working as care managers at primary care centers.

    Design: Qualitative, focus group study. Malterud’s method of systematic text condensation was used to analyse the data.

    Setting: Primary health care in the region of Västra Götaland and region of Dalarna in Sweden.

    Subjects: Eight nurses were trained during three days including treatment of depression and how to work as care managers. The training was followed by continuous support in the method.

    Main outcome measures: The nurses’s experiences and perceptions of working as care managers at primary care centers.

    Results: The care managers described their role as providing additional support to the already existing care at the primary care center, working in teams with a person-centered focus, where they were given the opportunity to follow, support, and constitute a safety net for patients with depression. Further, they perceived that the care manager increased continuity and accessibility to primary care for patients with depression. 

    Conclusion: The nurses perceived that working as care managers enabled them to follow and support patients with depression and to maintain close contact during the illness.  The care manager function helped to provide continuity in care which is a main task of primary health care. 

  • 339.
    Tapper, Amanda
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Olsson, Madelene
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Våld i nära relationer: En kvantitativ utvärderingsstudie av projektet "Våga Hjälpa!"2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Victims of domestic violence (DV) are growing, still the number of cases reported isn't. In Rättvik only half the amount of cases are reported compared to two years ago. Rättvik is working to reduce DV by starting the project "Våga Hjälpa!". The purpose of this study was to use a quantitative approach to examine if the project is known in Rättvik. The study's based on a survey with a 27% response rate. The analysis was made by SPSS and interpreted on the basis of conformity, the bystander effect and the Theory of Planned Behaviour. Results show that the majority haven't been in contact with DV and that the knowledge of how to act is evenly spread. The study concludes with an objective evalution of "Våga Hjälpa!" where our study results are related to the project objectives. The evaluation partly shows a fullfilled result but also some improvement opportunities.

  • 340.
    Torrång, Elin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Welam, Kari
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    ”Det är jag som bestämmer om min barndom ska få hindra mig eller inte”.: En kvalitativ studie om anknytning och resiliens hos barn som vuxitupp i en miljö präglad av alkoholmissbruk och/eller psykisk sjukdom.2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Previous research about children who have grown up with parents with mental illness and/or abuse has largely focused on negative aspects. The aim of this study was to through four autobiographies, examine individual factors that can contribute to a positive development, in children who have grown up with any adult with mental illness and / or alcohol abuse. The questions of the study concerned which individual characteristics contributed to well-being in adulthood, if some of these are common between the authors and memories of childhood that can be related to attachment. The theoretical foundation of the study consisted of attachment theory and resilience, in order to investigate the importance of the attachment for the children and how resistance can be developed in these children according to theory and research. The results of the study showed the majority of individual and common factors among the authors and the memories that could be related to the connection. The results were analyzed by thematic analysis, which derived 4 themes: safety net, connection, individual character and strategies for survival.

  • 341.
    Turunen, Päivi
    Dalarna University, School of Health and Social Studies, Social Work.
    Nordic community work in transition: - a change toward diversity and reflexivity2009In: Community Work in the Nordic Countries - New Trends / [ed] Gunn, Strand Hutchinson, Oslo: Universitetsforlag , 2009, p. 38-63Chapter in book (Other academic)
  • 342.
    Tägtgren, Ann-Sofie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Östberg, Kamilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    "Man gör det man kan, och finns där…": Hemtjänstpersonals upplevelser av den psykosociala arbetsmiljön2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of the study was to investigate how home care staff, working in a munici-pality with Sweden's highest rates of sick leave, experience their psychosocial work environment from the perspectives of role conflict, social support, stress of con-science and perceived obstacles and opportunities connected to their work. The method was qualitative semistructured individual interviews with five home care staff. The results showed that the respondents had experiences of role conflicts, lack of social support, and stress of conscience. Perceived barriers to a good psychosocial work environment where stress, lack of communication and information. Opportu-nities was perceived to be good communication, cooperation and time to nuture re-lationschip with the client. The study showed that respondents' perceptions of the psychosocial work environment was largely caused by the changes in old age care and home services. The study also showed that respondents are working under psy-chosocial conditions that can give the most adverse health effects.

  • 343.
    Törneman, Lena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Frykberg, Mimmi
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    "Jag slåss med rosa handskar, men de är fan inte fluffiga": En kvalitativ studie om verksamheten Pink Gloves Boxing2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study has been to examine what importance the Pink Gloves Boxing club has had for individual participant’s life situation with regards to psychosocial health, as a contribution to social work in Borlänge county. Furthermore, the aim has been to examine which parts of Pink Gloves Boxing have contributed to a possible change in the participants’ psychosocial life situation.

    Because of the aim to catch participants’ subjective experience of Pink Gloves Boxing, the material has been collected through semi-structured interviews with six participants. Through a thematic analysis of the material we found central themes and subthemes, which have formed the basis of the outcome. To analyze the result we have applied theories of empowerment and gender.

    All of the informants speak of better physique and increased mental health through their participation in Pink Gloves Boxing. Developed capacity of how to handle stress, aggression control and group affiliation are examples of the virtues of participation, as emphasized by informants. Positive components that emerged are the role of trainers, the cohesion of the group, the form of the exercise and the club’s arrangements, such as only female participants and group discussions.

  • 344.
    Udo, Camilla
    Dalarna University, School of Health and Social Studies, Social Work.
    Existential issues in surgical care: Nurses’ experiences and attitudes in caring for patients with cancer2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to explore surgical nurses’ experiences of being confronted with patients’ existential issues when caring for patients with cancer, and to examine whether an educational intervention may support nurses in addressing existential needs when caring for patients with cancer. Previously recorded discussions from supervision sessions with eight healthcare professionals were analysed (I), written descriptions of critical incidents were collected from 10 nurses, and interviews with open questions were conducted (II). An educational intervention on existential issues was pilot tested and is presented in Studies III and IV. The intervention was the basis of a pilot study with the purpose of testing whether the whole design of the educational intervention, including measurements instruments, is appropriate. In Study III and IV interviews with 11 nurses were conducted and 42 nurses were included in the quantitative measurements of four questionnaires, which were distributed and collected. Data was analysed using qualitative secondary analysis (I), hermeneutical analysis (II), and mixed methods using qualitative content analysis and statistical analyses (III-IV). Results in all studies show that existential issues are part of caring at surgical wards. However, although the nurses were aware of them, they found it difficult to acknowledge these issues owing to for example insecurity (I-III), a strict medical focus (II) and/or lacking strategies (I-III) for communicating on these issues. Modest results from the pilot study are reported and suggest beneficial influences of a support in communication on existential issues (III). The results indicate that the educational intervention may enhance nurses’ understanding for the patient’s situation (IV), help them deal with own insecurity and powerlessness in communication (III), and increase the value of caring for severely ill and dying patients (III) in addition to reducing work-related stress (IV). An outcome of all the studies in this thesis was that surgical nurses consider it crucial to have time and opportunity to reflect on caring situations together with colleagues. In addition, descriptions in Studies III and IV show the value of relating reflection to a theory or philosophy in order for attitudes to be brought to awareness and for new strategies to be developed.

  • 345.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work. CKF, Centrum för Klinisk Forskning.
    The concept and relevance of existential issues in healthcare encounters2014Conference paper (Refereed)
    Abstract [en]

    Rationale: Existential issues are relevant, not only in healthcare research, but also in healthcare practice as patients express needs relating to emotional and/or existential aspects of the new and often unexpected life situation they find themselves in. In critical situations, such as being diagnosed with a life-threatening illness, where a previously envisioned future and one’s basic security come under threat, existential issues often arise. Therefore, as a threat to existence, medical problems also become existential problems involving suffering and issues of life and death. Healthcare professionals need to be prepared for this. Thus, there is a need for clarification of what existential issues might.

    Aim: To illuminate and clarify the concept of existential issues in relation to nursing research and nursing practice.

    Method: Literature was searched in philosophical literature, PubMed, Cinahl and Psycinfo.

    Results: The concept of existential has its origin in philosophy and is common for all humans regardless of culture or religion. Existential issues often concern meaning, death, existential isolation and freedom. Although healthcare professionals are often aware of what existential issues may be, they feel unsure to communicate with patients and their loved ones about existential issues.

    Conclusion: Although acting in the professional capacity, the healthcare encounter is still primarily a human encounter where existential issues must be acknowledged and handled in order to support the patient to find meaning and thus relieve suffering. Further education with reflective discussions for healthcare professionals on challenging and difficult caring situations is important to support a deeper understanding of existential issues and to facilitate integration between phronesis-based and episteme-based knowledge. This in turn seems to enable communication about existential issues in caring situations.

  • 346.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    The concept and relevance of existential issues in nursing2014In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 18, no 4, p. 347-354Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to illuminate and clarify the concept existential issues in relation to nursing research and nursing practice.

    Methods: This article is a theoretical analysis of existential issues in relation to nursing.

    Results: Existential issues are becoming more commonly discussed and investigated in nursing research. Thus, it is important to clarify the concept.

    Conclusions: A clarification of existential issues may contribute to health care quality by increasing awareness of what existential issues are and drawing attention to the importance of discussing and reflecting on these issues, since practitioners in a caring profession will most likely encounter them.

  • 347.
    Udo, Camilla
    et al.
    Dalarna University, School of Health and Social Studies, Social Work.
    Danielson, Ella
    Sahlgrenska Akademien, Göteborgs Universitet; Mittuniversitetet.
    Henoch, Ingela
    Sahlgrenska Akademien, Göteborgs Universitet.
    Melin-Johansson, Christina
    Mittuniversitetet.
    Surgical nurses’ work-related stress when caring for severely ill and dying patients after participating in an educational intervention on existential issues2013In: The 7th International Conference on Social Work in Health and Mental Health: Pathways to Client-Centered Care: Oral Presentation Abstracts, 2013Conference paper (Refereed)
    Abstract [en]

    The aim was to describe surgical nurses’ perceived work-related stress in care of severely ill and dying patients after participating in an educational intervention on existential issues supervised by a clinical social worker.

    The concurrent data collections in this mixed methods study consisted of repeated interviews and questionnaires distributed on four occasions.

    Directly after the educational intervention, the nurses described working under high time pressure. They described being hindered in caring because of discrepancies between their caring intentions and what was possible in the surgical care context. Six months later, the nurses described a change in decision making, and a shift in the caring to make it more in line with their own intentions and patients’ needs rather than the organizational structure. At the same time they reported decreased feelings of work-related stress, decreased stress associated with work-load and feeling less disappointed at work.

    Results indicate that it may be possible to influence nurses’ work-related stress through an educational intervention. Reflection on ways of caring for severely ill and dying patients, from an existential perspective, had contributed to nurses’ enhanced independent decision-making in caring. This in turn appears to have decreased their feelings of work-related stress and disappointment at work.

  • 348.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work. Mittuniversitetet, Institutionen för hälsovetenskap; Karolinska institutet.
    Danielson, Ella
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Melin Johansson, Christina
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Existential Reflections among Nurses in Surgical Care2010In: Journal of Palliative Care, ISSN 0825-8597, Vol. 26, no 3, p. 228-229Article in journal (Refereed)
    Abstract [en]

    Objectives: To gain a deeper understanding of surgical nurses’ experiences of existential issues in cancer care.

    Methods: Written critical incidents were used to collect nurses’ descriptions and reflections of critical care situations involving existential issues. Individual face-to-face interviews were conducted as follow-up using semi-structured questions which were analysed with hermeneutical analysis.

    Preliminary results: The analysis showed that nurses in surgical care experience caring from different positions. Nurses either focus on the patient as a whole in the caring process or nurses focus more on medical information in the caring process. When focusing on the patient as a whole existential issues are considered to be a natural part of the caring process and nurses’ personal experiences help to enable encounters with the patients. When focusing more on the medical information in the caring process there was a transfer of responsibility to others, mainly the physicians.

    Preliminary conclusions: This study highlights that existential issues are indeed part of surgical cancer care derived from existential care situations. Nurses’ focus in the caring process differs. Nurses express different positions in caring and not all acknowledge patients’ existential issues as part of nurses’ responsibility. When lacking common strategies in the organization nurses derive existential caring strategies from personal experiences.

  • 349.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Danielson, Ella
    Melin-Johansson, Titti
    Existential Reflections among Nurses in Surgical Care2010In: 18th International Congress on Palliative Care, October 5-8, 2010, Montréal, Canada, Montréal, Canada, 2010Conference paper (Refereed)
    Abstract [en]

    Objectives: To gain a deeper understanding of surgical nurses’ experiences of existential issues in cancer care. Methods: Written critical incidents were used to collect nurses’ descriptions and reflections of critical care situations involving existential issues. Individual face-to-face interviews were conducted as follow-up using semi-structured questions which were analysed with hermeneutical analysis. Preliminary results: The analysis showed that nurses in surgical care experience caring from different positions. Nurses either focus on the patient as a whole in the caring process or nurses focus more on medical information in the caring process. When focusing on the patient as a whole existential issues are considered to be a natural part of the caring process and nurses’ personal experiences help to enable encounters with the patients. When focusing more on the medical information in the caring process there was a transfer of responsibility to others, mainly the physicians. Preliminary conclusions: This study highlights that existential issues are indeed part of surgical cancer care derived from existential care situations. Nurses’ focus in the caring process differs. Nurses express different positions in caring and not all acknowledge patients’ existential issues as part of nurses’ responsibility. When lacking common strategies in the organization nurses derive existential caring strategies from personal experiences.

  • 350.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jensfelt, Marcus
    Flink, Maria
    Perceptions of knowledge, research use and evidence-based practice among Swedish medical social workers – a qualitative study2019Conference paper (Refereed)
    Abstract [en]

    Background and aim: With the intention to do more good than harm, it is important to rely on practice that is rooted in evidence-based guidelines so that clients are given the exact care they need. Thus, from a client safety perspective, the social worker needs to apply evidence-based practice (EBP). Learning more about the medical social workers’ perceptions of EBP has the potential to contribute to an increased understanding of how best available knowledge can be implemented in medical social work settings to provide high quality and safe practice to clients. Therefore the aim of this study was to explore medical social workers’ perceptions of evidence-based practice (EBP), including factors relevant for the successful implementation of evidence into medical social work practice.

    Methods: This is a qualitative study. Eight focus group interviews were conducted that included 27 medical social workers. Data were analyzed using qualitative content analysis.

    Results: Analysis resulted in two categories: “knowledge in practice” and “challenges in relation to the implementation of EBP” and four subcategories: “practice based on research evidence or experience”, “obtaining new evidence of practice”, “research and the social work context”, and “barriers and facilitating factors”. Participants tended to perceive EBP as theoretical and positivistic while perceiving their own knowledge as eclectic and experience-based. Although they perceived the relevance of research findings to their practice, they expressed a need for support to translate research into policy and practice. They also reported that studies about their specific work were scarce.

    Conclusion and implications: The facilitating factors suggested by the medical social workers which concerned, e.g., a specially designated person responsible for supporting the increased use of research findings, support for prioritization of time, increased opportunities for the sharing of knowledge, and time for consultations, need to be considered when promoting the implementation of EBP within medical social work settings. The medical social workers’ suggestion for the facilitation of knowledge exchange needs further investigation.

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