1.
Emsing, Mikael, 1980-
(författare)
Conflict management & mental health among Swedish police officers & recruits
2022
Doktorsavhandling (övrigt vetenskapligt/konstnärligt) abstract
Introduction: An essential part of police work is handling people in distress, often related to some form of conflict that police officers are expected to handle in a professional manner. Thus, interpersonal and conflict management skills are essential for police officers. Further, police work has been hailed as one of the most complex and stressful jobs that one can have. While important progress has been made in relation to how the complex and stressful nature of police work affects the individual officers - less is known about the timing and onset of these effects. Similarly, while there is a growing body of research into police conflict management, more research is needed to deepen our understanding of police conflict management, not least in the Swedish context. The overall aim of the present thesis was to contribute to existing knowledge about police work by investigating conflict management and mental health among Swedish police recruits and officers.Materials and methods: The present thesis used a mixed-methods approach and is built on four sub-studies. Sub-study 1 examined the evidence base for current practices, methods, and training in conflict management by means of a scoping review. Sub-study 2 used semi-structured interviews to examine how police officers perceived conflict and conflict-management and their training within the subject. Results from sub-study 2 where also used increating items for the instrument developed in sub-study 4. Sub-study 3 used a quantitative design to examine the mental health status of Swedish police recruits using the SCL-90 questionnaire. Sub-study 4 documented the initial steps towards developing an instrument to measure conflict behaviors and attitudes to conflict management among police officers and evaluated the psychometric properties of this instrument.Results: A large proportion of the studies included in the scoping review were conducted in the US and manyfocused-on use of force. The results also indicate that a lack of available data, unified definitions and experimental as well as longitudinal research designs makes it difficult to draw causal conclusions regarding the effectiveness of training in conflict management. In the interviews, respondents described conflict largely in terms of interpersonal conflicts, and focused less on intrapersonal conflict. The complexity and importance of the role played by instructors during probationary training was also salient in their descriptions. As for mental health status, recruits overall reported scores that where similar to the general population. A small number of recruits (n = 15) reported scores that where above the patient mean of the Swedish general population in the corresponding age group. The intended factor structure of the instrument developed could not be operationalized in the instruments current form, but the instrument could still provide insights and provides a basis for further development of the instrument.Conclusions: To enhance our understanding on police conflict management, scholars and police departments should work together to agree upon unified definitions on key concepts related to this topic. More research using longitudinal and experimental designs are needed to further develop training interventions related to conflict management. While a small number of recruits reported scores above the Swedish patient mean, extant research has indicated that stigmas surrounding mental health among police could lead to unconstructive coping behaviors. Further research on mental health among not only Swedish police officers but also recruits, could focus on helpseeking-behaviors and stigmas related to mental health to provide valuable insights on the topic. The instrument developed within the present thesis needs further development but nonetheless represents a first step towards examining individual differences in relation to police conflict management behaviors and attitudes towards conflict.
2.
Jemberie, Wossenseged Birhane, 1985-
(författare)
Alcohol and aging : a multimethod study on heterogeneity and multidimensionality
2023
Doktorsavhandling (övrigt vetenskapligt/konstnärligt) abstract
Background and Objectives: With an ageing population, the number of older persons with substance use problems, particularly problematic alcohol use, is increasing. Despite growing recognition of the negative consequences of problematic alcohol use on older persons, there is a dearth of knowledge about the alcohol use profiles and the dimensionality of alcohol problems in older people. Moreover, little is known about older persons’ experiences and perspectives on alcohol use in relation to their ageing and their personal goals regarding treatment and recovery. This thesis aimed to (i) describe the characteristics of older persons who accessed municipal substance use treatment and care services (addiction services) and to investigate their future hospitalization; (ii) examine the heterogeneity and multidimensionality of problematic alcohol use among older persons; and (iii) to shed light on the experiences and perspectives of older persons regarding ageing, alcohol problems and recovery.Methods: For studies I-III, municipal Addiction Severity Index (ASI) assessment data (between 2003 and 2017) from adults aged 50 years and older were used to select the study samples. Generalized linear regression models investigated hospitalization related outcomes among 3624 older persons in Study-I. In Study-II, a latent class analysis was applied on ASI data from 1747 individuals with alcohol problems. Study-III linked the ASI data from Study-II to hospital discharge and mortality data forming time-to-repeated-event dataset; Andersen-Gill regression model with a robust variance estimator was used for the analysis. Study-IV applied qualitative content analysis on interview data from ten older persons recruited from a specialist outpatient clinic for alcohol treatment. Results: Nearly three-fourth of older persons assessed for substance use severity at municipal addiction services were later hospitalized (Study-I). Individuals diagnosed with substance use disorders, psychiatric or dual diagnoses had more cumulative hospitalized days, higher rates of hospital readmissions, and shorter time to first admission following an initial ASI assessment at municipal addiction services (Study-I). Five distinct groups of older persons with comparable alcohol problem severity but with variation in onset age, psychiatric comorbidities, polysubstance use, social support and gender composition were identified (Study-II). The five groups varied in risks of repeated hospitalizations due to substance use and psychiatric disorders (Study-III). Older persons experienced their ageing and alcohol use having a dynamic interplay (Study-IV). They needed to constantly negotiate with their environment to maintain a positive ageing trajectory. They perceived moderate alcohol use fosters healthy ageing, but over time, experienced their alcohol use as unsustainable and a threat to their pursuit of healthy ageing. Stigma and ambivalence delayed treatment seeking (Study-IV). They accessed treatment programs which respected their preferences and autonomy, engaged them in goal setting and strengthened their agency. After reducing their alcohol use, positive changes in their biopsychosocial functioning encouraged them to continue their recovery journey even in the presence of setbacks (Study-IV).Conclusion: Most older persons who access municipal addiction services are hospitalized repeatedly. Many older persons with alcohol problems live with medical and psychiatric comorbidities suggesting multiple care needs from health and social care services. Incorporating older persons’ desire for healthy ageing into alcohol treatment plan can facilitate treatment engagement and recovery. Many older persons aim to moderate their alcohol consumption. Clinicians can deliver person-centered care for older persons, by considering their heterogeneity in treatment goals, biopsychosocial functioning, and available resources. A multidimensional identification of alcohol use profiles could improve treatment by establishing the variation in alcohol problems among older treatment seekers. Older persons stay engaged in alcohol treatment programs which value their experiences and expertise, incorporate their personal treatment and life goals, respect their autonomy and agency, and involve them as active participants. Sensitizing service providers on old age substance use problems could provide multiple points of contact for screening of older persons and earlier referral to treatment. A streamlined data sharing within and between health and social care services fosters timely and equitable care and facilitates an integrated and person-centered care across the continuum.
3.
Padyab, Mojgan, 1976-
(författare)
Client violence toward Iranian social workers : A national study
2011
Doktorsavhandling (övrigt vetenskapligt/konstnärligt) abstract
Introduction Client violence toward social workers has become recognized as a common problem, and major concern has been raised with regard to its impacts on the workers’ practice, and physical and psychological health. More than half a century has passed since the social work profession was established in Iran, and yet client violence and the associated health-related consequences remain unexplored. This thesis aims to address this gap in knowledge. Methods A national survey was conducted involving 390 social workers from the Centres for Socially Injured People (CSIP), affiliated to the Social Affairs Department of the State Welfare Organization, Iran. The survey included self-administered questionnaires, namely, the Workplace Violence in the Health Sector questionnaire, the General Health Questionnaire-28 (GHQ-28), the Ways of Coping questionnaire, the Burnout Measure, and the Rosenberg Self-esteem Scale. Results A high proportion of CSIP social workers (67%) have experienced violence. Psychological violence was about three times more common than physical violence. A high tendency of not reporting psychological violence to managers/supervisors was found. Psychological violence was associated with poorer mental health. Social workers with experience of psychological violence were found to be more worried about occurrences of violent events. Worrying about violence was significantly correlated with poorer mental health. Active coping had a direct effect on health, suggesting a poorer health status with more frequent use of active coping. Burnout was experienced by 10.9% of social workers, and 17.4% were found to be at risk of developing burnout symptoms. Low self-esteem and experience of violence were associated with burnout. Conclusion The results suggest the importance of not neglecting cases of client violence and of putting the health and safety of social workers on top of the agenda. A victimized social worker with limited resources at work needs to note that coping skills may reduce the impact of stressors, not only by changing the stressors themselves, but also by changing how the social worker responds to them.
