| 1. |
- Bergström, Malin, et al.
(författare)
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Children with two homes: Psychological problems in relation to living arrangements in Nordic 2-to 9-year-olds
- 2019
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Ingår i: Scand J Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 47:2, s. 137-145
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Joint physical custody, children spending equal time in each parents' respective home after a parental divorce, is particularly common in Nordic compared with other Western countries. Older children have been shown to fare well in this practice but for young children there are few existing studies. The aim of this paper is to study psychological problems in 2- to 9-year-old Nordic children in different family forms. Methods: Total symptom score according to the Strengths and Difficulties Questionnaire as well as scores showing externalizing problems were compared among 152 children in joint physical custody, 303 in single care and 3207 in nuclear families through multiple linear regression analyses. Results: Children in single care had more psychological symptoms than those in joint physical custody (B = 1.08; 95% CI 0.48 to 1.67) and those in nuclear families had the least reported symptoms (B = -0.53; 95% CI -0.89 to -0.17). Externalizing problems were also lower in nuclear families (B = -0.28, 95% CI -0.52 to -0.04) compared with joint physical custody after adjusting for covariates. Conclusions: Young children with non-cohabiting parents suffered from more psychological problems than those in intact families. Children in joint physical custody had a lower total problem score than those in single care after adjusting for covariates. Longitudinal studies with information on family factors before the separation are needed to inform policy of young children's post-separation living arrangements.
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| 2. |
- Berntsson, Leeni, 1938, et al.
(författare)
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Health, economy and social capital in Nordic children aged 13-17 years and their families: changes between 1984, 1996 and 2011
- 2015
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Ingår i: International journal of healthcare. - : Sciedu Press. - 2377-7338 .- 2377-7346. ; 2:1, s. 51-61
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Tidskriftsartikel (refereegranskat)abstract
- Background: Three repeated cross-sectional surveys, using representative samples of children, aged 2-17 years, stratified for age and sex, were conducted in each of the five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) in 1984, 1996 and 2011. The aim of the present study was to analyze how the health of Nordic 13-17 years old children developed over time, using results from the three surveys in relation to changes in economy and social capital. Methods: Data from 2,905 children in 1984, 2,922 in 1996 and 2,257 in 2011 were collected using mailed questionnaires. Indicators in three areas were used. The Health indicator was taken as absence of psychosomatic complaints. Economy was represented by social class, housing and disposable income. Social capital contained absence of bullying, the child’s organized group activities, parents playing with their children, and parents’ position of trust. Three composite indices one for each area were formed and called Health, Economy and Social Capital Index. Results: There were statistically significant increases of psychosomatic health complaints for children 13-17 years in all the Nordic countries, strongest among girls, at the same time as the economy and social capital of the families increased, particularly in the first period (1984-1996). Conclusions: In spite of the families’ growing economy and improved standard of living there is an increasingly harsh climate in society, with stress, dissatisfaction, bullying and mental health problems. It supports conclusions from other studies that only economic growth is not enough for the full wellbeing of the population. It also supports the importance of the social cohesion, affiliation and solidarity, advanced and reinforced by equitable distribution of the wealth. Social cohesion is important for schooling, on the values of self help, equity, to seek solutions for health among youths.
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| 3. |
- Berntsson, Leeni, 1938, et al.
(författare)
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Health, economy and social capital in Nordic children and their families. A comparison between 1984 and 1996.
- 2006
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Ingår i: CHILD: CARE; HEALTH AND DEVELOPMENT. - 1365-2214. ; 32:4, s. 441-451
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of the study was to analyse the development in the health of children that occurred in the five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) between 1984 and 1996 and relate it to the changes in economic growth and social capital in these countries during the same period. METHODS: Two cross-sectional studies covered a representative sample of children, aged 2-17 years in each country, a total of 10,291 in 1984 and 10,317 in 1996. The data were collected by mailed questionnaires. Statistical associations between a health indicator (the absence of psychosomatic complaints), economic indicators (social class, housing and disposable income) and social capital indicators (parents' and children's organized group activities, parents playing with their children and the absence of bullying) within samples and between corresponding values in different samples across subgroups (defined by country and area of residence) were evaluated using multiple linear regression. RESULTS: In both surveys, there was a statistically highly significant association between the health indicator and the social capital indicators, whereas the economy indicators were not related to either of the other two types of measure. Change in health was associated positively with change in social capital and negatively with change in economy. CONCLUSION: The study provides strong support for the concept of social capital as an important determinant of children's health.
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| 4. |
- Birkeland, Anna-Lena, 1955-
(författare)
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Psychosocial aspects of living with congenital heart disease : child, family, and professional perspectives
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: The vast majority of infants born with congenital heart disease (CHD) reach adulthood because of the developments in cardiology in recent decades. This thesis aims to describe the psychosocial situation of child/adolescent cardiac patients and their families, investigate the situation faced by parents and siblings initially and over time, investigate the approaches paediatric cardiologists use in encountering the family, and describe the teamwork occurring in paediatric cardiology teams (PCTs) in Sweden.Theoretical framework: The theoretical framework was based on a quality of life model applied to children, a stress-coping model, and a psychosocial approach including support, profession, and teamwork.Methods: The research combines quantitative data collection/analysis and qualitative research interviews/content analysis.Results: Complexity: The three grades of medical complexity differed regarding the number and severity of psychosocial symptoms, the children with the most complex CHD having the most severe symptoms. The most frequent symptoms in the whole patient group regarding various spheres were: healthcare and treatment-related needs in the external sphere, family symptoms in the interpersonal sphere, and mental/psychosomatic symptoms in the personal sphere.Coping: Being informed of a child’s/sibling’s heart disease has emotional consequences, so information, communication, and support are essential. Breaking the news of a child’s disease can be described as a turning point still significant after ten years. The professionalism of the doctor’s approach in breaking the news is crucial.Profession: Among paediatric cardiologists, how to break bad news to a family is an important concern, evident in findings regarding the significance of trust and confidence and the use of various emotional positions. Paediatric cardiologists commonly wish to be skilled at handling this situation, and attaining the needed skills calls for reflection, education, and sharing experience.Team: PCTs in Sweden aim and try to work in a structured way. In PCTs, there is a need for leadership, resource coordination, coaching, and a forum for joint reflection. Dependence on the physician on the team was identified in all PCTs. The challenge of managing increasing complexity at both the family and system levels requires interprofessional teams.Conclusions: These studies illustrate the psychosocial complexity and the need of psychosocial support. Emotional consequences, communication, information and support are essential both for the children, parents/families and for the professionals. To manage this complexity organizational alteration action plans are required. There is a need for a forum to stimulate dialogue and common reflection in the local PCT and at the regional and national centres.
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| 5. |
- Bång, Karl-Lennart, et al.
(författare)
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Handbok för kapacitetsanalys med hjälp av simulering
- 2014
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Syftet med föreliggande handbok är att beskriva hur trafiksimulering kananvändas som en alternativ metod eller komplement till analytiska metoderför att bestämma kapacitet och framkomlighet. Liksom metodbeskrivningarnai TRV2013/64343 är beskrivningarna avsedda att kunna användas för att medhjälp av trafiksimulering uppskatta effekterna av en given utformning isamband med planering, konsekvensanalys, projektering och drift avvägtrafikanläggningar. Simulering kan användas som ett komplement till deanalytiska metoderna, eller som ersättning i fall som inte täcks av dessametoder. Härigenom minskas risken för onödiga kostnader förorsakade avsåväl över- som underkapacitet.
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| 6. |
- Clausson, Eva K., 1952-, et al.
(författare)
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Ethical challenges for school nurses in documenting schoolchildren's health
- 2008
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Ingår i: Nursing Ethics. - 0969-7330 .- 1477-0989. ; 15:1, s. 40-51
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Tidskriftsartikel (refereegranskat)abstract
- This study explored Swedish school nurses' experiences of school health record documentation. Fifty per cent of a representative sample of Swedish school nurses (n = 129) reported difficulties with documenting mental and social health problems in family relationships, schoolchildren's behaviour, and school situations. Ethical considerations concerning fears of misinterpretation and practical barriers to documentation were expressed as reasons for their worries. Mental and social ill health is an increasing and often dominating problem among schoolchildren, thus proper documentation is a basic issue, both for individuals and for the population as a whole. School nurses obviously need professional guidance regarding documentation and ethical challenges. Systematic effort should be directed towards recognition and support of these nurses' unique opportunities to consider, follow and promote all aspects of schoolchildren's health.
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| 7. |
- Clausson, Eva K., et al.
(författare)
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Ethical challenges for school nurses in documenting schoolchildren's health
- 2008
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Ingår i: Nursing Ethics. - : SAGE Publications Ltd. - 0969-7330 .- 1477-0989. ; 15:1, s. 40-51
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Tidskriftsartikel (refereegranskat)abstract
- This study explored Swedish school nurses' experiences of school health record documentation. Fifty per cent of a representative sample of Swedish school nurses (n = 129) reported difficulties with documenting mental and social health problems in family relationships, schoolchildren's behaviour, and school situations. Ethical considerations concerning fears of misinterpretation and practical barriers to documentation were expressed as reasons for their worries. Mental and social ill health is an increasing and often dominating problem among schoolchildren, thus proper documentation is a basic issue, both for individuals and for the population as a whole. School nurses obviously need professional guidance regarding documentation and ethical challenges. Systematic effort should be directed towards recognition and support of these nurses' unique opportunities to consider, follow and promote all aspects of schoolchildren's health.
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| 8. |
- Clausson, Eva K., 1952-
(författare)
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School health nursing : perceiving, recording and improving schoolchildren's health
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim of this thesis is to explore School health nursing through school nurses’ descriptions of school children’s health and to analyse factors influencing the recording of schoolchildren’s health in the School Health Record (SHR). An additional aim is to evaluate family nursing interventions as a tool for the school nurses in the School Health Service (SHS).Methods: The thesis comprises four papers. A combination of qualitative and quantitative methods was used through individual interviews with a strategic sample of school nurses (n=12) (PI), a national survey to a representative sample of school nurses (n=129) (PII, III) and the implementation of family nursing models developed in Canada with girls in their early adolescence with recurrent health complaints and their families (n=4) in co-operation with their school nurses (n=2) (PIV). The Strengths and Difficulties Questionnaire (SDQ) was used as pre and post test. Evaluation interviews were conducted with the families and the nurses separately. Qualitative content analyses were used to analyze the interview text with the school nurses and the families. Manifest content analysis was used to analyze the free text answers of the survey and the evaluation interview with the school nurses. Descriptive statistical analyses were used to describe demographic data in all four papers. The SDQ was hand-scored statistically.Findings: The findings showed that nurses judged the schoolchildren’s mental health as deteriorated, especially in socially disadvantaged areas and more generally among girls expressed as psychosomatic symptoms. Individual factors related to lifestyle affected the schoolchildren’s physical health, and the mental health was, to a large extent, affected by the school environment and family relations. The latter seemed to be the most important factor affecting schoolchildren’s mental health. The basis for the school nurses judgement of the physical health was health check-ups and the health dialogues. Spontaneous visits were more commonly used to judge the mental health. Recording schoolchildren’s mental health was a challenge for school nurses. Difficulties were related to ethical considerations, tradition, lack of time and the improper structure of the SHR. Fears of marking the schoolchild for life related to the schoolchild itself, the parents or to other authorities/successive caregivers were brought up as hinders for recording mental and social health. Family sessions may be useful within the profession when handling recurrent health complaints among adolescence girls. The girls and their families experienced relief, they felt confirmed and that their feelings and reactions were normal in that situation. The families became aware of their own strengths and possibilities and this was supported by the SDQ which showed an increased well-being. The school nurses valued this way of working and meant that the sessions seemed to start a changing process within the families.Conclusions: The results indicate that school nurses have a deep knowledge about schoolchildren’s health which is not used to its full potential in a public health perspective. However, the experienced difficulties recording schoolchildren’s mental health seem obvious, which would demand developing the SHR for the needs of today. Family sessions in SHS with the school nurse as a collaborator with the family seemed useful and may be transferable to other health problems expressed by the schoolchildren. Bronfenbrenner’s ecological systems theory and other models for health determinants are used to illustrate the school nurse as a mediator working on the bridge over different health streams with schoolchildren’s health on an individual and a population level.
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| 9. |
- Clausson, Eva K.
(författare)
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School health nursing : perceiving, recording and improving schoolchildren's health
- 2008
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Doktorsavhandling (populärvet., debatt m.m.)abstract
- Syfte: Avhandlingens övergripande syfte är att undersöka skolsköterskors uppfattning om skolbarns hälsa och att analysera faktorer som påverkar dokumentation av skolbarns hälsa i skolhälsovårdsjournalen. Ett ytterligare syfte är att utvärdera modeller för familjeinterventioner som redskap för skolsköterskor i skolhälsovård.Metoder: Avhandlingen består av fyra delarbeten. En kombination av kvalitativa och kvantitativa metoder användes. I delarbete I genomfördes intervjuer med ett strategiskt urval av skolsköterskor (n=12). Intervjuerna analyserades med kvalitativ innehållsanalys. I delarbeten II och III distribuerades en nationell enkät till ett representativt urval av Sveriges skolsköterskor (n=129). Manifest innehållsanalys användes vid analys av de öppna frågorna. I delarbete IV genomfördes en interventionsstudie med familjesamtal, inspirerad av modeller för familjefokuserad omvårdnad utvecklade i Kanada. Skolflickor i tidig adolescens med återkommande subjektiva hälsoproblem (n=4) och deras föräldrar i samarbete med deras verksamma skolsköterskor (n=2) ingick i studien. Separata utvärderingsintervjuer genomfördes med familjer och skolsköterskor. Intervjuerna analyserades med kvalitativ och manifest innehållsanalys respektive. The Strengths and Difficulties Questionnaire (SDQ) användes som före/efter test vid interventionen och resultatet bearbetades statistiskt manuellt. Deskriptiv statistik användes för analys av demografisk data i samtliga delarbeten.Resultat: Resultatet visade att skolsköterskorna bedömde skolbarnens mentala hälsa som försämrad särskilt bland flickor och i socioekonomiskt utsatta områden. Individuella livsstilsfaktorer påverkade skolbarnens fysiska hälsa och den mentala hälsan var i stor utsträckning påverkad av skolmiljö och familjerelationer. Det sistnämnda verkade vara den mest betydelsefulla påverkansfaktorn för skolbarnens mentala hälsa. Bedömningen av den fysiska hälsan baserades på hälsokontroller och hälsosamtal medan spontana besök var vanligare för bedömning av den mentala hälsan.Dokumentation av mentala hälsa var en utmaning för skolsköterskorna. Svårigheterna kunde relateras till etiska överväganden, tradition och tidsbrist samt till skolhälsovårdsjournalens struktur som inte ansågs uppfylla dagens krav. Skolsköterskorna uttryckte en rädsla för att journalanteckningarna skulle märka skolbarnet för livet. Framtida tolkningar relaterade till skolbarnet själv, föräldrar eller andra/påföljande vårdgivare uttrycktes som hinder för att dokumentera mental och social hälsa. Familjesamtal visade sig vara användbara i skolhälsovården. De medverkande flickorna och deras familjer kände sig bekräftade i att deras känslor och reaktioner var normala. De sade sig bli medvetna om egna styrkor och möjligheter vilket styrktes av SDQ som visade ett ökat välbefinnande efter sammankomsterna, både hos skolbarnen och hos föräldrarna. Skolsköterskorna var positiva till att arbeta med familjesamtal och upplevde sig mer som samverkanspartner än som expert. Samtalen ledde till att en förändringsprocess startade i familjerna enligt skolsköterskorna.Slutsatser: Resultatet indikerar att skolsköterskor har en djup kunskap om skolbarns hälsa som sannolikt kunde tas tillvara på ett bättre sätt ur ett folkhälsoperspektiv på såväl nationell som lokal nivå. Behovet av att utveckla skolhälsovårdsjournalen efter dagens behov och fördjupad kunskap om de upplevda svårigheterna att dokumentera skolbarns mentala hälsa är uppenbar. Familjesamtal, där skolsköterskan intar en roll som samverkanspartner, visade sig användbara och kan sannolikt överföras till andra hälsoproblem bland skolbarn. Bronfenbrenners utvecklingsekologiska systemteori och andra modeller för hälsodeterminanter används för att illustrera skolsköterskans arbete med skolbarns hälsa på såväl en individuell nivå som folkhälsonivå.
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| 10. |
- Clausson, Eva K., 1952-, et al.
(författare)
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Schoolchildren's health as judged by Swedish school nurses : a national survey
- 2008
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Ingår i: Scandinavian Journal of Public Health. - 1403-4948 .- 1651-1905. ; 36:7, s. 690-697
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To use school nurses' knowledge and experience for a better understanding of schoolchildren's health problems and their association to socioeconomic background and gender. METHODS: Mail questionnaires were sent to a nationally representative, random sample of Swedish school nurses (n=129). The questionnaire included structured and open-ended questions asking for school nurses' judgement of schoolchildren's health status; changes over the previous two years; estimation of schoolchildren's most common reasons for consulting the school nurse; and estimation of factors influencing schoolchildren's health. RESULTS: Swedish school nurses judged schoolchildren's mental health to have deteriorated during the previous two years with increasing health complaints, especially among girls and in disadvantaged housing areas. Disturbed family relations were considered as one important explanatory factor. Girls were more inclined to consult school nurses with subjective health complaints. Boys more often consulted the nurses with physical injuries. CONCLUSIONS: School nurses work closely with the children and meet them continuously during the school age period. They have a genuine knowledge of schoolchildren's health, which should be used even more, both in research and practice. The results may be applicable in other countries with similarly organized school health systems.
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