| 11. |
- Mangrio, Elisabeth, 1978-, et al.
(author)
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Risk for mental illness following exposure to violence and threats among newly arrived refugees
- 2022
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In: BMC Research Notes. - : BioMed Central (BMC). - 1756-0500. ; 15:1
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Journal article (peer-reviewed)abstract
- Objective: There is an association between pre-migration exposure to threats and violence, and the risk for mental illness among newly arrived refugees (NAR). The aim of this study is therefore to investigate the effect of pre-migration violent and threatening experiences on the mental health of NAR in Sweden. The participants were recruited between February 2015 and February 2016, undergoing the naturalisation process in Sweden. In total, 681 questionnaires were returned (response rate of 39.5%).Results: The results showed that almost 50% of the sample were at risk for mental illness. Analysis of pre-migration exposure to violence or threats, and risk for mental illness, showed a significant odds ratio for violence as well as for threats. Analysing men and women separately resulted in a significant odds ratio for women for pre-migration threats. For men, pre-migration violence and threats were significantly associated with the risk for mental illness. The host society receiving NAR must screen for mental illness and be prepared to provide support and care for refugees who were exposed to violence or threats, and who are subsequently at risk for mental illness. This must be considered in order to improve health and subsequently the social integration of refugees.
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| 12. |
- Mangrio, Elisabeth, 1978-, et al.
(author)
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Segregation within welfare societies : Communication Barriers to Migrants`Healthcare in Scandinavia
- 2022
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In: Global Health Communication For Immigrants and Refugees. - New York : Routledge. - 9781032132358 - 9781003230243
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Book chapter (peer-reviewed)abstract
- This chapter compares health communication towards migrants living at the margins of society – undocumented migrants, asylum seekers, and refugees – within the different Scandinavian countries (Denmark, Norway, and Sweden), to understand the present state of health communication and its role in both strengthening and, where being unequal, segregating societal inclusion within the Nordic region. We know that such migrants often experience health challenges related not only to their migratory journey, but often caused by the precarious situation in which they are placed upon arrival in host countries. Past studies show significant challenges in obtaining care, and difficulties with communication, including cultural awareness. Where health communication fails to meet the needs of a diverse population, we see growing societal segregation that often follows racialized structures with long-term consequences for society.
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| 13. |
- Mangrio, Elisabeth, 1978-, et al.
(author)
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Social relations and mental ill-health among newly arrived refugees in Sweden : a cross-sectional study
- 2022
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In: PLOS Global Public Health. - : PLoS. - 2767-3375. ; 2:7
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Journal article (peer-reviewed)abstract
- Background: Previous research indicates that social relations have an impact on the well-being of refugees and that well-being is important for effective integration into the host country. Few studies in Sweden have, to the best of our knowledge, looked at the association between social relations and mental ill-health among newly arrived refugees. The aim is to investigate what effect social relations have on the mental health of newly arrived refugees in the south of Sweden. Methods: A cross-sectional study was conducted in Scania, the southernmost county of Sweden, between February 2015 and February 2016. The study population consisted of newly arrived adult refugees speaking Dari or Arabic, who received the civic and health information that is part of an introduction course for all newly arrived refugees. Results: Individuals who rarely met with friends had higher odds of experiencing mental ill-health (OR=1.70, 95% CI, 1.03-2.82) than individuals who frequently spent time with friends. Furthermore, individuals who seldom attended social/community meetings or activities in an organisation or group, such as a sports association or another kind of association, a church, a mosque, or women’s or men’s meetings, had higher odds of mental ill-health (OR=1.58, 1.1-2.28), compared to those who frequently did so. Conclusions: The study suggests a link between spending time with friends, as well as engaging in social/community activities, and the mental health of newly arrived refugees in the southernmost county of Sweden, which is one of the counties in Sweden that received the highest number of refugees. The results are in line with a previous study on the same subject in Sweden.
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| 14. |
- Mangrio, Elisabeth, 1978-, et al.
(author)
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The Need for Parental Support for Migrant Parents in Transition Into Sweden : A Perspective
- 2022
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In: Frontiers in Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 10
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Journal article (peer-reviewed)abstract
- Migration is a stressful experience and research shows that newly arrived migrants in Sweden suffer from different challenges and struggle to relate to parenting in a new culture that is different from their own. The Swedish Child Health Services (CHS) focuses on promoting health among children, as well as supporting parents in parenting. Although this is a goal, migrant parents participate at lower rates in parental support groups. This paper aims to discuss how the Swedish CHS can support these families and address the need for improvement in the parental support offered to migrant parents during transition into their host country. In addition, this paper also aims to review and discuss the advantages of using a community-based participatory research approach together with the Swedish CHS to identify and apply culturally appropriate support programs to increase health literacy among migrant parents. The Swedish government decided to place greater emphasis and resources on supporting parents and promoting equal health among families in Sweden, with special emphasis on migrants and other vulnerable groups. This report from the Swedish government indicates the importance of creating knowledge about new ways, methods, and actions that may be needed to increase this support. One suggestion of this paper is to provide culturally appropriate healthcare work using a community-based participatory research approach, where migrant parents themselves are actively involved in the development of support programs. This approach will not only provide migrant families knowledge and support, it will also build on their needs and the challenges they can share, and receive support to overcome.
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| 15. |
- Mangrio, Elisabeth, 1978-, et al.
(author)
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Working With Refugees' Health During COVID-19 : The Experience of Health- and Social Care Workers in Sweden
- 2022
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In: Frontiers in Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 10
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Journal article (peer-reviewed)abstract
- IntroductionIn Sweden, often seen as one of the most egalitarian countries, the COVID-19 pandemic exposed high levels of health inequality, especially harming people with a refugee background. This is also despite Sweden’s image as a refugee-friendly country. In this context, the aim of this paper is to better understand how Swedish health- and social workers have reacted to the health- and social needs of refugees during the pandemic. The Swedish case is particularly interesting because, as seen in the paper, health- and social workers had the task of communicating health guidance to refugees who were sometimes more reliant on information from abroad where the consensus on COVID-19 restrictions ran contrary to the approach recommended by the Swedish public health authority.MethodThe study utilizes a qualitative content analysis of 13 in-depth interviews with health- and social workers in Sweden, active in the care of refugees within different kinds of health- and social care settings. ResultsThe analysis showed that healthcare services have remained open during the pandemic but with new precautions at reception areas impacting how refugees access healthcare. As discussed in the article, the shift to digital tools has particularly impacted refugees, worsening already existing barriers to healthcare services faced by those with refugee status. Public health recommendations were poorly designed to the needs of refugees whose living conditions often prevented them from self-isolation and social distancing. Furthermore, Sweden’s initially non-restrictive approach to the pandemic instructed health- and social-workers to encourage refugees to take far fewer precautions (e.g. self-isolation, home-schooling, pregnant women to avoid virus hotspots) compared both with European neighbours and the international media typically used by refugees. When Sweden shifted towards a more restrictive approach, health- and social-workers had to revise their guidance in relation to the new recommendations around precautions.ConclusionRefugees have faced increased barriers to maintaining their health and well-being during the pandemic that exceed those experienced by the rest of the Swedish population. Refugees have, in general, taken precautions in regard to social distancing and followed recommendations but faced challenges with social distancing due to isolation and crowded living. Public health authorities have often failed to acknowledge that individuals use increasingly diverse sources of knowledge when trying to protect their health, and that not everyone has access to the knowledge needed to access healthcare and social systems. At the same time, there is a need to acknowledge that refugees are sometimes a source of expertise that was ignored by the Swedish health and social system during the pandemic. There is a need for urgent efforts to halt the worsening health conditions for this specific group, but also to counter knock-on societal effects and rising health inequity.
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| 16. |
- Nayeb, Laleh
(author)
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Lika men ändå olika : Språkscreening av enspråkiga och flerspråkiga barn vid 2,5-3 år på BVC
- 2022
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Doctoral thesis (other academic/artistic)abstract
- Children who do not develop their language as expected are at risk of difficulties in school and with peer relations. The Swedish Child Health Services (CHS) offer preventive health surveillance, including language screening, at 2.5-3 years. However, the screening has only been validated for monolingual children. The aims of the thesis were to explore CHS nurses’ experiences of language screening of bilingual children, to evaluate the 3-year screening for language disorder for use at 2.5 years, and to assess the stability of the children’s diagnoses and the classification accuracy of the screening after 6 months. In Study I, 863 nurses answered a web-based survey. Half of the nurses simplified the screening processes for bilingual children, and 74% postponed referrals to speech and language services. About 80% believed that language development was slower in bilingual children which was the strongest predictor of simplified screening practices. In Studies II and III, 105 monolingual and 111 bilingual children were screened and clinically assessed at age 2.5. The screening classification accuracy for monolinguals vs bilinguals screened in both their languages was: sensitivity 91% vs 88%, specificity 91% vs 82%, PPV 56% vs 67%, and NPV 99% vs 94%, respectively. Study IV reassessed 141 children (48 mono- and 93 bilinguals) at age 3, i.e. all children with a positive outcome at age 2.5 from studies II and III, and matched children from the same studies with negative outcomes. The number of new cases with language disorder (n=4) was about the same as the number who had recovered (n=5) at age 3. These few changes were statistically significant, but not considered to be of clinical relevance since the classification accuracy of the screening was still within 95 CI after 6 months. The screening classification accuracy for monolinguals vs bilinguals was: sensitivity 71% vs 81%, specificity 93% vs 82%, PPV 39% vs 67%, and NPV 98% vs 90%. In conclusion, the modified language screening can be recommended for use at age 2.5. Bilingual children who don’t pass the screening in Swedish, should be screened in their mother tongue using a standard procedure. The wait-and-see strategy reported by the nurses in Study I was not supported as screening results remained stable between 2.5 and 3 years. There is a need to implement new evidence-based routines in child health services to equitably screen both monolingual and bilingual children for language disorder.
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| 17. |
- Sjögren Forss, Katarina, et al.
(author)
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Interprofessional Teamwork to Promote Health : First-Time Parents' Experiences of a Combined Home Visit by Midwife and Child Health Care Nurse
- 2022
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In: Frontiers in Pediatrics. - : Frontiers Media S.A.. - 2296-2360. ; 10
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Journal article (peer-reviewed)abstract
- Background: To achieve the requisites for a child’s healthy development and to reducehealth inequalities, it is important to promote health initiatives at an early stage in a child’slife and to include the parents. Home visits by healthcare professionals have been foundto have positive health effects for both the baby and the parents. From an extended homevisit programme in Sweden, our aim was to illuminate first-time parents’ experience of ahome visit conducted by a midwife and a child health care nurse 1–2 weeks postnatal.Methods: Data was collected by interviews (n = 13) with first-time parents. Thetranscribed texts were analyzed using inductive content analysis.Results: The participants’ experiences could be understood from the two themes, Atrust in the professionals and Feeling safe as a new parent. The participants experiencedthat the midwives and the child health care nurses complemented each other andappreciated to get knowledge and information from both professions. In their own home,they felt secured and relaxed, and the professionals could help them provide a safe homeenvironment for the child.Conclusion: By meeting both professionals at the same time and in their own home,the participants experienced that the needs of the baby and their needs and concernsas new parents were included and supported.
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| 18. |
- Stenberg, Marie, et al.
(author)
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Collaboration between first year undergraduate nursing students : A focused ethnographic study
- 2022
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In: Nurse Education in Practice. - : Elsevier. - 1471-5953 .- 1873-5223. ; 64
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Journal article (peer-reviewed)abstract
- AIM: The aim was to explore collaboration between first year undergraduate nursing students in a three-year bachelor program during clinical skills lab practices.BACKGROUND: The ability to collaborate is important in the nursing profession to ensure patient safety. Thus, efforts supporting nursing students with learning activities emphasizing this ability is crucial in nurse education as a preparation for the requirements of the nursing profession. Collaborative learning models are described as ways that support the students' interaction during education. However, collaboration between students has shown to have challenges such as negative competition and confrontations. This stresses the need to explore the collaboration between students to find ways to support the interaction.DESIGN: The study was conducted with a focused ethnographic approach.METHOD: Data were generated by participant observations during one semester, involving 70 h observation of 87 first year nursing students for 6 months and 24 training sessions in clinical skills lab practices. Two focus group discussions were used to elaborate students' views of collaboration and to provide an opportunity for follow up questions and interpretations from the observations. Field notes and focus group discussions were interpreted as one unit of analysis conducted with thematic network analysis. A global theme were synthesized from organizational and additional basic themes presenting the overall metaphor of the students' collaboration.RESULT: The global theme, Between adaptation and non-conformity, revealed a field of tension in the nursing students' collaboration. One the one hand, the global theme involved the students' ability to adopt to new knowledge and to being a nursing student in a clinical skills lab and to others' perspective. On the other hand, non-conformity creates a collaboration with less reflection between the students and non-synchronized and time-consuming laboratory work.CONCLUSION: Collaborative activities in nurse education fosters and challenges nursing students' collaboration required for clinical practices and later in the nursing profession. By the presented scaffolding efforts, nurse educators can arrange a learning environment that can support the collaboration between students and facilitate the transition into the profession.
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| 19. |
- Larsen, Risa, et al.
(author)
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Interpersonal Communication in Transcultural Nursing Care in India : A Descriptive Qualitative Study
- 2021
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In: Journal of Transcultural Nursing. - : Sage Publications. - 1043-6596 .- 1552-7832. ; 32:4, s. 310-317
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Journal article (peer-reviewed)abstract
- Introduction: Good communication is crucial for safe and effective nursing care and is necessary in building interpersonal relationships with patients. The increase of global interactions in health care adds to the necessity of developing culturally competent communication in nursing. The purpose of the study was to gain a deeper understanding of interpersonal communication as experienced by nurses working in culturally diverse hospitals in India. Method: A descriptive qualitative method, analyzing 12 semistructured interviews conducted with nurses at two hospitals. Results: The study's themes focus on tools and techniques for working with culturally diverse patients and how to sustain the quality of care in diverse hospital settings. Language resources, language tools, and cultural knowledge were useful aids for nurses when communicating with transcultural patients. It helped the nurses gain confidence and foresee patient needs. Discussion: Highlighting transcultural interpersonal communication techniques within nursing offers a safer and more productive practice of nursing care.
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| 20. |
- Mangrio, Elisabeth, 1978-, et al.
(author)
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An Extended Home Visit Programme Within the Swedish Child Healthcare System for First-Time Parents in Scania, Sweden : A Study Protocol
- 2021
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In: Frontiers in Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 9
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Journal article (peer-reviewed)abstract
- Background: The Swedish Child Healthcare (CHC) system aims to provide equal and fair health care for all children and families in Sweden. Currently in Sweden, the CHC offers every family two home visits during the child's 1st year of life. During 2019, an extended home visit programme, called Grow Safely, was started in the region of Scania for first-time parents. The aim of the extended home visit programme was to provide support for first-time parents in order to improve the overall health of the child and family and contribute to better conditions for equal health. Instead of two home visits during the 1st year, a subsample of first-time parents would receive six visits during the child's first 15 months. These six visits would be conducted by CHC nurses and social workers, midwives, and dental assistants. In the present paper, we describe a research project related to the regional extended home visit programme; the project aims to illuminate the experiences of the participants and to investigate the perceived benefits of the programme in relation to improved health, social and emotional interaction between parent and child, and attitudes toward authorities and surrounding society.Method/Analysis: In order to evaluate the introduction of the intervention, three qualitative interview studies and one quantitative study with follow-up questionnaires will be conducted. Since the research project also comprises studies focusing on the implementation and expectations of politicians, civil servants, organizational managers, and professionals working within the programme, interviews within these fields will be conducted.Discussion: Sweden has a well-established CHC programme, but improvements are always possible. Previous research has shown that home visits are an effective tool to improve both the child's physical and mental health as well as the parents' well-being. However, this kind of intervention involves a significant investment from all organizations involved in the home visits; hence, it is important that the intervention is evaluated. The research project described in the present paper intends to examine the impact of the intervention, and its findings will aid decisionmakers in determining the future of the home visit programme.
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