| 1. |
- Pelto-Piri, Veikko, 1959-, et al.
(författare)
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The ethical landscape of professional care in everyday practice as perceived by staff : a qualitative content analysis of ethical diaries written by staff in child and adolescent psychiatric in-patient care
- 2012
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - London : BioMed Central. - 1753-2000. ; 6:1, s. 18-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although there has been some empirical research on ethics concerning the attitudes and approaches of staff in relation to adult patients, there is very little to be found on child and adolescent psychiatric care. In most cases researchers have defined which issues are important, for instance, coercive care. The aim of this study was to provide a qualitative description of situations and experiences that gave rise to ethical problems and considerations as reported by staff members on child and adolescent psychiatric wards, although they were not provided with a definition of the concept.METHODS: The study took place in six child and adolescent psychiatric wards in Sweden. All staff members involved with patients on these wards were invited to participate. The staff members were asked to keep an ethical diary over the course of one week, and data collection comprised the diaries handed in by 68 persons. Qualitative content analysis was used in order to analyse the diaries.RESULTS: In the analysis three themes emerged; 1) good care 2) loyalty and 3) powerlessness. The theme 'good care' contains statements about the ideal of commitment but also about problems living up to the ideal. Staff members emphasized the importance of involving patients and parents in the care, but also of the need for professional distance. Participants seldom perceived decisions about coercive measures as problematic, in contrast to those about pressure and restrictions, especially in the case of patients admitted for voluntary care. The theme 'loyalty' contains statements in which staff members perceived contradictory expectations from different interested parties, mainly parents but also their supervisor, doctors, colleagues and the social services. The theme 'powerlessness' contains statements about situations that create frustration, in which freedom of action is perceived as limited and can concern inadequacy in relation to patients and violations in the workplace.CONCLUSIONS: The ethical considerations described by child and adolescent psychiatric care staff are multifaceted and remarkably often concern problems of loyalty and organization. These problems frequently had a considerable influence on the care provided. It seems that staff members lack a language of ethics and require both an ethical education and a forum for discussion of ethical issues.
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| 2. |
- Stickley, Andrew, et al.
(författare)
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Peer victimisation and its association with psychological and somatic health problems among adolescents in northern Russia
- 2013
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - : Springer Science and Business Media LLC. - 1753-2000. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A growing body of evidence from countries around the world suggests that school-based peer victimisation is associated with worse health outcomes among adolescents. So far, however, there has been little systematic research on this phenomenon in the countries of the former Soviet Union. The aim of this study was to examine the relation between peer victimisation at school and a range of different psychological and somatic health problems among Russian adolescents.METHODS: This study used data from the Social and Health Assessment (SAHA) - a cross-sectional survey undertaken in Arkhangelsk, Russia in 2003. Information was collected from 2892 adolescents aged 12-17 about their experiences of school-based peer victimisation and on a variety of psychological and somatic health conditions. Logistic regression analysis was used to examine the association between victimisation and health.RESULTS: Peer victimisation in school was commonplace: 22.1% of the students reported that they had experienced frequent victimisation in the current school year (girls - 17.6%; boys - 28.5%). There was a strong relationship between experiencing victimisation and reporting worse health among both boys and girls with more victimisation associated with an increased risk of experiencing worse health. Girls in the highest victimisation category had odds ratios ranging between 1.90 (problems with eyes) and 5.26 (aches/pains) for experiencing somatic complaints when compared to their non-victimised counterparts, while the corresponding figures for boys were 2.04 (headaches) and 4.36 (aches/pains). Girls and boys who had the highest victimisation scores were also 2.42 (girls) and 3.33 (boys) times more likely to report symptoms of anxiety, over 5 times more likely to suffer from posttraumatic stress and over 6 times more likely to experience depressive symptoms.CONCLUSION: Peer victimisation at school has a strong association with poor health outcomes among Russian adolescents. Effective school-based interventions are now urgently needed to counter the negative effects of victimisation on adolescents' health in Russia.
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| 3. |
- Isaksson, Johan, et al.
(författare)
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Risky sexual behaviour among Russian adolescents : association with internalizing and externalizing symptoms
- 2021
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Ingår i: Child and Adolescent Psychiatry and Mental Health. - : BioMed Central. - 1753-2000. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Risky sexual behaviour (RSB) is regarded as a major health problem during adolescence. Russia has one of the highest rates of teenage pregnancy, abortion and newly diagnosed HIV infections in the world, but research on RSB in Russian youth has been limited. To address this deficit, this study examined the role of several factors, including internalizing and externalizing symptoms, in RSB among Russian adolescents. Methods: Self-reported data were collected from 2573 Russian adolescents aged 13–17 years old (59.4 % girls; Mean age = 14.89) regarding RSB (unprotected sex, early pregnancy, multiple sexual partners and substance use during sexual encounters). Information was also obtained on externalizing (conduct problems and delinquent behaviour) and internalizing (depression, anxiety and posttraumatic stress) symptoms, as well as interpersonal risk and protective factors (affiliation with delinquent peers, parental involvement and teacher support). Hierarchical multiple binary logistic regression analysis was used to examine the associations between these variables and RSB. Results: Boys reported engaging in more RSB than girls. Externalizing symptoms and affiliation with delinquent peers were most strongly associated with RSB, whereas symptoms of anxiety were negatively associated with RSB. There was an interaction effect for sex and affiliation with delinquent peers on RSB with boys reporting RSB when having more delinquent peers. Neither parental involvement nor teacher support were protective against RSB. Conclusions: Early detection of and interventions for RSB and associated externalizing symptoms may be important for adolescent physical and mental wellbeing. Affiliation with delinquent peers should, especially among boys, be regarded as a risk marker for RSB.
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