| 1. |
- Meurling, Jennifer, et al.
(författare)
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An online tiered screening procedure to identify mental health problems among refugees
- 2023
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Ingår i: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Many refugees suffer from mental health problems due to stressful and traumatic events before, during, and after migration. However, refugees are facing a wide variety of barriers, limiting their access to mental health care. Internet-based tools, available in several languages, could be one way to increase the availability of mental health services for refugees. The present study aimed to develop and test a screening tool to screen for clinically relevant symptoms of psychiatric disorders common among refugees (i.e. Depression, Anxiety, Post-traumatic stress disorder, and Insomnia). We, designed, translated, and adapted an internet-based tiered screening procedure suitable for use with the largest refugee populations residing in Sweden. The tool aims to accurately identify symptoms of mental distress (Tier 1), differentiate between symptoms of specific psychiatric disorders (Tier 2), and assess symptom severity (Tier 3). We tested the overall efficiency of using a tiered screening procedure. METHODS: Seven hundred fifty-seven refugees residing in Sweden, speaking any of the languages Arabic, Dari, Farsi, English, or Swedish, completed an online questionnaire following a three-tiered procedure with screening instruments for each tier. In this study, the Tier 3 scales were used as reference standards for clinically relevant symptoms, to evaluate screening efficiency in terms of accuracy and reduction of item burden in previous tiers. RESULTS: The results show that the tiered procedure could reduce the item burden while maintaining high accuracy, with up to 86% correctly assessed symptoms and few false negatives with moderate symptoms and above (at most 9%), and very few with severe symptoms (at most 1.3%). DISCUSSION: This study generated an accurate screening tool that efficiently identifies clinically relevant symptoms of common psychiatric disorders among refugees. Using an adapted online tiered procedure to screen for multiple mental health issues among refugees has the potential to facilitate screening and increase access to mental health services for refugees. We discuss the utility of the screening tool and the necessity of further evaluation.
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| 2. |
- Sarkadi, Anna, Professor, 1974-, et al.
(författare)
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Evaluation of the Teaching Recovery Techniques community-based intervention for unaccompanied refugee youth experiencing post-traumatic stress symptoms (Swedish UnaccomPanied yOuth Refugee Trial; SUPpORT) : study protocol for a randomised controlled trial
- 2020
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Ingår i: Trials. - : NLM (Medline). - 1745-6215. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In 2015, 162,877 persons sought asylum in Sweden, 35,369 of whom were unaccompanied refugee minors (URMs). Refugee children, especially URMs, have often experienced traumas and are at significant risk of developing mental health problems, such as symptoms of post-traumatic stress disorder (PTSD), depression and anxiety, which can continue years after resettlement. The Swedish UnaccomPanied yOuth Refugee Trial (SUPpORT) aims to evaluate a community-based intervention, called Teaching Recovery Techniques (TRT), for refugee youth experiencing PTSD symptoms.METHODS/DESIGN: A randomised controlled trial will be conducted in which participants will be randomly allocated to one of two possible arms: the intervention arm (n = 109) will be offered the TRT programme, and the waitlist-control arm (n = 109) will receive services as usual, followed by the TRT programme around 20 weeks later. Outcome data will be collected at three points: pre-intervention (T1), post-intervention (T2; about 8 weeks after randomisation) and follow-up (T3; about 20 weeks after randomisation).DISCUSSION: This study will provide knowledge about the effect and efficiency of a group intervention for URMs reporting symptoms of PTSD in Sweden. TRIAL REGISTRATION: ISRCTN, ISRCTN47820795. Prospectively registered on 20 December 2018.
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| 3. |
- Warner, Georgina, et al.
(författare)
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Evaluation of the teaching recovery techniques community-based intervention for accompanied refugee children experiencing post-traumatic stress symptoms (Accompanied refugeeS In Sweden Trial; ASsIST) : study protocol for a cluster randomised controlled trial
- 2020
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 10:7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Refugee children have often experienced traumas and are at significant risk of developing mental health problems, such as symptoms of post-traumatic stress disorder (PTSD), depression and anxiety, which can continue for years after resettlement. The Accompanied refugeeS In Sweden Trial (ASsIST) aims to evaluate a community-based intervention, called 'Teaching Recovery Techniques' (TRT), for accompanied refugee minors experiencing PTSD symptoms. METHODS/DESIGN: A cluster randomised controlled trial will be conducted in which participants will be randomly allocated to one of the two possible arms: the intervention arm (n=113) will be offered the TRT programme and the waitlist-control arm (n=113) will receive services as usual, followed by the TRT programme around 20 weeks later. Outcome data will be collected at three points: pre-intervention (T1), post-intervention (T2; c.8 weeks after randomisation) and follow-up (T3; c.20 weeks after randomisation). ETHICS AND DISSEMINATION: Ethical approval was granted by the Regional Ethical Review Board in Uppsala (Ref. 2018/382) (24th February 2019). Results will be published in scientific journals. TRIAL REGISTRATION DETAILS: ISRCTN17754931. Prospectively registered on 4th June 2019.
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| 4. |
- Aamodt, A., et al.
(författare)
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Case-based reasoning for assessment and diagnosis of depression in palliative care
- 2010
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Ingår i: Proceedings - IEEE Symposium on Computer-Based Medical Systems. ; , s. 480-485
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Konferensbidrag (refereegranskat)abstract
- The goal of the research presented is to create a computational framework and system architecture for clinical decision support in palliative care. The application focused is the classification of depression. The method under investigation is case-based reasoning, motivated by the complexity of the domain and a lack of generalized principles of sufficient coverage and strength for diagnosis and treatment. A system architecture is described and exemplified through an implemented prototype. The outcome of the research so far is a system that captures the properties intended, and for which a clinical test set-up has been defined. © 2010 IEEE.
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| 5. |
- Arving, Cecilia, et al.
(författare)
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Satisfaction, utilisation and perceived benefit of individual psychosocial support for breast cancer patients : A randomised study of nurse versus psychologist interventions
- 2006
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 62:2, s. 235-243
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Tidskriftsartikel (refereegranskat)abstract
- Objective: In a prospective, randomised study, individual psychosocial support performed by: (1) specially trained oncology nurses (INS) or (2) psychologists (IPS) were compared with respect to utilisation, satisfaction and perceived benefit. Methods: Between December 1997 and December 1999, consecutive breast cancer patients (n = 120) were included at start of adjuvant therapy (chemo-, endocrine and/or loco-regional radiotherapy). Data were collected by an extended version of the 'IPS-patient satisfaction questionnaire' within I week after termination of the support intervention. Questionnaires were also mailed to all patients 6, 12 and 18-24 months after inclusion. Levels of distress were collected with the Hospital Anxiety and Depression Scale (HADS) and Impact of Event Scale (IES) questionnaires. Results: The patients were highly satisfied with the individual psychosocial support intervention they received, irrespective of which profession provided the support. However, the patients in the INS group reported higher levels of benefit regarding disease-related problems, regardless if the patients at baseline reported low or high levels of distress. Conclusions: Patients were highly satisfied with an individual psychosocial support intervention. In areas dealing with somatic aspects, the group intervened by nurses were more satisfied than the one by psychologists. Practice implications: Individual psychosocial support by specially trained nurses is a realistic alternative in routine cancer care.
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| 6. |
- Bjärtå, Anna, 1974-, et al.
(författare)
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Assessing Severity of Psychological Distress Among Refugees With the Refugee Health Screener, 13-Item Version
- 2018
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Ingår i: Journal of Nervous and Mental Disease. - 0022-3018 .- 1539-736X. ; 206:11, s. 834-839
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Tidskriftsartikel (refereegranskat)abstract
- The recent inflow of refugees to Sweden has put pressure on health care as well as revealing a need for methods regarding assessment of refugees' mental health status. The present study investigated the use of the Refugee Health Screener (RHS; Hollifield et al., 2013) to distinguish among severity levels of symptoms of psychological distress in refugees. Refugees residing in asylum accommodations (n = 510) were screened with RHS-13, together with screeners for depression, anxiety, and posttraumatic stress disorder (PTSD). Risk for mild, moderate, or severe levels of depression, anxiety, or/and PTSD was used as screening proxy. Receiver operating characteristic analysis rendered cutoff scores of 11, 18, and 25, for mild, moderate, and severe symptoms, respectively. Evaluated against each symptom scale separately, cutoffs performed well. Cutoff 11, previously identified by Hollifield et al. (2016), was also confirmed. However, utilization of additional cutoffs could improve refugee mental health by guiding clinical decision making.
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| 7. |
- Brenne, Elisabeth, et al.
(författare)
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Depressed patients with incurable cancer : which depressive symptoms do they experience?
- 2013
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Ingår i: Palliative & Supportive Care. - 1478-9515 .- 1478-9523. ; 11:6, s. 491-501
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Forskningsöversikt (refereegranskat)abstract
- OBJECTIVE: Diagnosing depressive disorders in palliative care is challenging because of the overlap between some depressive symptoms and cancer-related symptoms, such as loss of appetite and fatigue. In order to improve future assessment of depression in palliative care, depressive symptoms experienced by patients receiving pharmacological treatment for depression were assessed and compared to the American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for major depressive disorder.METHOD: Thirty Norwegian (n = 20) and Austrian (n = 10) patients with advanced cancer were included. Semistructured interviews on symptom experiences were conducted and transcribed verbatim. By the phenomenographic method, patients' symptom experiences were extracted and sorted by headings, first individually and then across patients. The patients subsequently rated 24 symptoms numerically including the DSM-IV depression criteria.RESULTS: Lowered mood and a diminished motivational drive were prominent and reflected the two main DSM-IV symptom criteria. A relentless focus on their actual situation, restlessness, disrupted sleep, feelings of worthlessness, feelings of guilt, and thoughts of death as a solution were variably experienced. Appetite and weight changes, fatigue and psychomotor retardation were indistinguishable from cancer symptoms. All these symptoms reflected DSM-IV symptom criteria. Some major symptoms occurred that are not present in the DSM-IV symptom criteria: despair, anxiety, and social withdrawal. The numerical ratings of symptoms were mainly in accordance with the findings from the qualitative analysis.SIGNIFICANCE OF RESULTS: Despair, anxiety, and social withdrawal are common symptoms in depressed patients with incurable cancer, and, therefore, hypothesized as candidate symptom criteria. Other symptom criteria might need adjustment for improvement of relevance in this group of patients.
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| 8. |
- Bring, Annika, et al.
(författare)
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Coping Patterns and Their Relation to Daily Activity, Worries, Depressed Mood, and Pain Intensity in Acute Whiplash-Associated Disorders
- 2013
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Ingår i: International Journal of Behavioral Medicine. - : Springer Science and Business Media LLC. - 1070-5503 .- 1532-7558. ; 20:2, s. 293-303
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDThere is a lack of knowledge regarding how individuals with acute whiplash-associated disorders (WAD) appraise and cope with situation-specific stressors.PURPOSEThe aim of the study was to describe the daily process of coping reported in a daily coping assessment by individuals with acute WAD within 1 month after the accident. More specifically, profiles of coping strategies were identified and patterns between stressors, primary and secondary appraisals, and coping strategy profiles were described in relation to reported level of activity, worries, depressed mood and pain intensity during the day.METHODA descriptive and exploratory design was applied. Two hundred and twenty-nine whiplash-associated disorders-daily coping assessment (WAD-DCA) collected during seven consecutive days from 51 participants with acute WAD in Sweden, were included. Cluster analysis was used to obtain coping strategy profiles and data were graphically visualised as patterns through the coping process.RESULTSWhen measuring coping as a daily process relating to the specific stressful situation, different coping pocess patterns appeared. During days with a high degree of physical and mental well-being, high self-efficacy beliefs seemed to be working as an important secondary appraisal, whereas during days with a low degree of physical and mental well-being primary appraisals of the stressor as a threat and catastrophic thoughts were present in the coping process.CONCLUSIONSEarly identification of situational- and individual-specific stressors, appraisals and coping efforts as measured by the WAD-DCA may contribute to the understanding of the coping process in the acute stage of WAD and its possible impact on recovery and adjustment.
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| 9. |
- Bring, Annika, et al.
(författare)
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Daily stressors in patients with acute whiplash associated disorders
- 2012
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 34:21, s. 1783-1789
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Stressors in acute whiplash associated disorders (WAD), as reported on a daily basis, have hitherto been neglected in research. The primary aim of this study was to describe the most stressful daily situation or event reported by individuals with acute WAD within a month of a whiplash trauma. Another aim was to describe the meaning and significance of these daily stressors, i.e. primary appraisal. Method: A descriptive design with a content analysis approach was used. 260 WAD-daily coping assessments (WAD-DCA) generated during 1 week by 51 participants with acute WAD were included in the study. Stressors were analysed using qualitative content analysis. Results: The reported stressors generated 13 categories covering a wide range of stressful situations in daily life related to (i) work, (ii) physical symptoms, (iii) feelings and cognitions, (iv) family and home responsibilities and (v) recreation. The majority of the stressors were appraised as "expected" as well as "disabling". Most threatening stressors were related to work, driving and feelings/cognitions. Conclusions: The wide variety of stressors indicates that it is not only pain itself that influences daily life in acute WAD. Early identification of individual and situation-specific stressors gives new data regarding what bothers individuals suffering from WAD after a collision and may be helpful in understanding the coping process in relation to specific stressors and stressor appraisals.
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| 10. |
- Demetry, Youstina, et al.
(författare)
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Individually Tailored and Culturally Adapted Internet-Based Cognitive Behavioral Therapy for Arabic-Speaking Youths With Mental Health Problems in Sweden : Qualitative Feasibility Study
- 2023
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Ingår i: JMIR Formative Research. - : JMIR PUBLICATIONS, INC. - 2561-326X. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Background: Most forcibly displaced refugees in Sweden originate from the Arab Republic of Syria and Iraq. Approximately half of all refugees are aged between 15 and 26 years. This particular group of youths is at a higher risk for developing various mental disorders. However, low use of mental health services across Europe has been reported. Previous research indicates that culturally adapted psychological interventions may be suitable for refugee youths. However, little is known about the feasibility, acceptability, and efficacy of such psychological interventions. Objective: This study aimed to explore the feasibility, acceptability, and preliminary efficacy of an individually tailored and culturally adapted internet-based cognitive behavioral therapy for Arabic-speaking refugees and immigrant youths in Sweden. Methods: A total of 17 participants were included to participate in an open trial study of an individually tailored and culturally adapted internet-based cognitive behavioral therapy targeting common mental health problems. To assess the intervention outcome, the Hopkins Symptom Checklist was used. To explore the acceptability of the intervention, in-depth interviews were conducted with 12 participants using thematic analysis. Feasibility was assessed by measuring treatment adherence and by calculating recruitment and retention rates. Results: The intervention had a high dropout rate and low feasibility. Quantitative analyses of the treatment efficacy were not possible because of the high dropout rate. The qualitative analysis resulted in 3 overarching categories: experiences with SahaUng (the treatment), attitudes toward psychological interventions, and personal factors important for adherence. Conclusions: The findings from this study indicate that the feasibility and acceptability of the current intervention were low and, based on the qualitative analysis, could be increased by a refinement of recruitment strategies, further simplification of the treatment content, and modifications to the cultural adaptation.
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