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- Fängström, Karin, 1980-
(författare)
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‘I don’t even remember anything’ : Optimising the choice of method when interviewing preschoolers
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is increasing need and demand in various contexts to take children’s perspectives into account, including the views and opinions of the youngest children. However, listening to the voices of children is a challenging and complex task, and the field is normatively loaded. There is thus a growing need for valid and reliable methods and techniques that aid children to verbalise their experiences. The overall aim of this thesis was to examine the ability of the In My Shoes computer assisted interview and a Standard verbal interview to elicit accurate information and evaluative content, when used with preschool-aged children and determine their suitability in relation to situationally shy children.Our studies show that the two interview methods, in general, provided equally accurate and complete statements. In addition, the IMS interview can be a more useful and suitable tool during the rapport phase with situationally shy children compared to the Standard verbal method. For non-shy children, the interview methods were equally adequate. In relation to evaluative information, the recommended open-ended questions in the Standard verbal interview were insufficient. Children appeared to need evaluative questions in order to provide evaluative content. Examining the ability of IMS to elicit subjective experiences showed that using IMS aided children to provide detailed and varied descriptions of emotions, somatic experiences, and objects such as toys. Thus, when choosing the optimal child interview method, there are several aspects that need to be considered, including the degree to which children’s statements need to be accurate and complete and/or contain evaluative information and the child’s level of shyness. These studies have increased the number of evaluated methods for interviewing children and contributed to new knowledge about the challenging task of optimising the choice of method for interviewing preschoolers.
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| 2. |
- Johansen, Kine
(författare)
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Towards an evidence-based assessment of early motor performance in the child health services : Psychometric properties and clinical utility of the Structured Observation of Motor Performance in Infants
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The Swedish child health services (CHS) have a unique position in that they reach almost all children 0-6 years of age. The child health nurse has the main responsibility for developmental surveillance. Twelve scheduled visits with the nurse during the child’s first year of life make this an ideal setting to systematically identify infants with motor problems, ranging from asymmetric head positioning that may lead to plagiocephaly to more severe forms such as cerebral palsy (CP). However, the CHS lack evidence-based methods to assess motor development.The Structured Observation of Motor Performance in Infants (SOMP-I) assesses motor performance in two domains, i.e. level of motor development and quality of motor performance. SOMP-I is quick, non-invasive, requires minimal handling, and is suitable for a busy clinical setting when applied by physiotherapists. Given the importance of early detection, the increased likelihood of detecting motor problems when using evidence-based assessment methods and the key role of nurses within the CHS, the overall aim of this thesis was investigate the psychometric properties and clinical utility of SOMP-I when used by child health nurses. Furthermore, we aimed to establish the ability of SOMP-I to detect CP.Our results show that child health nurses can reliably assess the level of motor development in infants using SOMP-I. More variability was found when they assessed the infants’ quality of motor performance. Although the nurses expressed concern about introducing a more time-consuming assessment in an already tight schedule, they were able to integrate the SOMP-I assessment in routine care. The nurses reported that barriers to using SOMP-I were mostly logistic and practical in nature, and they pointed out the necessity of education and practice in order to become proficient assessors. Using SOMP-I appears to have supported the nurses in the decision-making process regarding motor performance in routine care. SOMP-I detected CP during the first months of life in neonatal intensive care recipients.To our knowledge, these studies are the first to evaluate child health nurses’ assessment of early motor performance using an evidence-based assessment method in routine care. The results are promising, but further research is warranted.
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| 3. |
- Öberg, Mariella, 1970-
(författare)
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Exposed to Violence
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Violence against women is a crime against human rights and a major global public health issue affecting the lives of millions of girls and women worldwide. Exposure to violence poses a threat to health, both in the short and the long term. To minimize the devastating consequences of violence it is central to identify girls and women who have been exposed and to find possible risk factors that may serve as targets for prevention efforts.The main aims of this thesis were to study the prevalence of sexual, physical and psychological violence among women in Sweden and to explore possible associations to violence and polyvictimization during childhood as well as sociodemographic factors.In a family planning unit, 1226 women seeking either termination of pregnancy or contraceptive counseling were recruited to answer questions about different types of violence. Of the women seeking termination of pregnancy, 29% reported experiences of intimate partner violence, compared to 22% of women seeking contraceptive counseling. Of all the women attending a family planning unit, 27% reported lifetime experiences of sexual violence.A survey containing questions about lifetime experiences of sexual, physical and/or psychological violence was sent to a national sample of 10 000 women and 10 000 men. Lifetime experiences of at least one type of severe violence were reported by over 50% of both women and men. Sexual violence was more than three times more common among women compared to men.Rape/attempted rape in adulthood was more common among women who were single, had college-level education and those who had been unemployed or had received social welfare payments.Exposure to sexual, physical and psychological violence in childhood was highly associated with rape/attempted rape in adulthood among the women respondents.Conclusion: Lifetime experiences of violence are common among women in Sweden. Multiple exposure to violence during childhood is the most potent risk factor for exposure to sexual violence in adulthood. The findings underscore the importance of detecting individuals who have been exposed in order to offer help, and may contribute to the development of effective prevention programs, especially among children and adolescents.
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| 4. |
- Engström, Maria, et al.
(författare)
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Psychosocial risk factors in families of young children : A trial of the Safe Environment for Every Kid (SEEK) Model in Sweden
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundThe Safe Environment for Every Kid (SEEK) model is a structured, evidence-based approach that helps identify and address prevalent psychosocial problems among caregivers and facilitates support and services. The aim of the present study was to analyze self-reported financial worries, depressive symptoms, parental stress, alcohol misuse and intimate partner violence in families of children <6 years of age as expressed in the SEEK Parent Screen Questionnaire - Sweden (PSQ-S) completed at regular child health visits. MethodsThis study has a longitudinal design with consecutive, clinical-encounter-based sampling, and is part of a cluster-randomized controlled trial evaluating the SEEK model in Swedish child health services (CHS). Data were collected from parents’ responses to the Swedish SEEK Parent Screening Questionnaire (PSQ-S) used universally at five age-specific health visits during the intervention period from April 2018 through March 2020. Fully completed PSQ-S (n=7483) were analyzed using descriptive statistics regarding each respective risk factor and potential differences between groups with respect to child age and parent gender were analysed using Pearson’s Chi-square. Trends over time for each risk factor were analysed using the Mantel-Haenszel test.FindingsOver half of the PSQ-S (53%) had at least one positive screen and the problems were common among both mothers and fathers throughout the child’s first five years of life. Overall rates of positive screens decreased by 41% for child safety problems, 52% for economic worries, 52% for depressive symptoms, 66% for parental stress and 73% for IPV during the intervention period (p-values ranged from 0.028 to <0.001) but not for alcohol misuse.ConclusionParents of young children frequently reported psychosocial risk factors in their encounters with the CHS nurse when the SEEK model was used. There was a significant decrease in positive screens over the course of the intervention, possibly because problems had been addressed and families’ psychosocial situation indeed had improved.
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| 5. |
- Engström, Maria, et al.
(författare)
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Validation of the Swedish Version of the Safe Environment for Every Kid (SEEK) Parent Screening Questionnaire
- 2023
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Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 23
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPsychosocial risk factors in the home may impair children’s health and development and increase their risk of maltreatment. The Safe Environment for Every Kid (SEEK) model helps address these problems, and aims to strengthen families, support parents and parenting, and thereby promote children’s health, development, wellbeing and safety. The SEEK model includes use of the Parent Screening Questionnaire (SEEK-PSQ) at routine preventive child health visits, assessment of their responses and, when indicated, referral to relevant services. The aim of the present study was to evaluate the psychometric properties of the Swedish version of the SEEK-PSQ (PSQ-S). MethodsThis study is part of a cluster-randomised controlled trial of SEEK in the Swedish child health services. To validate the PSQ-S, parents (n=852) with children 0-18 months of age were invited to complete a survey comprising the PSQ-S as well as evidence-based standardized instruments for the targeted psychosocial risk factors. Data from 611 (72%) parents were analysed regarding sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for each risk factor.ResultsAs a whole, the PSQ-S had a sensitivity of 93%, specificity of 52%, PPV of 67% and NPV of 87%. For mothers and fathers combined, sensitivity was 80% for economic worries, 89% for depressive symptoms, 78% for parental stress, 47% for intimate partner violence (IPV) and 70% for alcohol misuse. Specificity was highest for IPV and alcohol misuse (91%) and lowest for depressive symptoms (64%). NPV values were high (81-99%) and PPV values were low to moderate (22-69%) for the targeted problems. Sensitivity was higher for mothers compared to fathers for economic worries, depressive symptoms and IPV. This difference was particularly evident for IPV (52% for mothers, 27% for fathers). ConclusionThe SEEK-PSQ-S demonstrated good psychometric properties for identifying economic worries, depressive symptoms, parental stress and alcohol misuse but low sensitivity for IPV. The PSQ-S as a whole showed high sensitivity and NPV, indicating that most parents with or without the targeted psychosocial risk factors were correctly identified.Trial registrationISRCTN registry, study record 14429952 (https://doi.org/10.1186/ISRCTN14429952)Registration date 27/05/2020.
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| 6. |
- Fäldt, Anna
(författare)
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Targeting toddlers’ communication difficulties at the Swedish child health services – a public health perspective
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Communication is fundamental for human interaction. Communication difficulties have a negative impact on children’s learning, relations, and quality of life and are regarded as a public health problem. The Swedish child health services have a possibility to prevent communication difficulties and their consequences for the individual through universal interventions and identification of affected children. This thesis investigates interventions at the levels of universal prevention, identification, and indicated intervention for children with communication difficulties.Study I explored associations between family and child health centre characteristics and exposure to a universal preventive communication intervention. Questionnaires answered by 2326 mothers and 2077 fathers were analysed. Few parents reported that they had been exposed to the intervention. Positive associations were seen to high socioeconomic status and if the child was of low age at the start of the intervention or was oldest among siblings. Study II described the study design employed to investigate the identification and effects of an indicated intervention. Study III used a mixed-methods design to explore child health service nurses’ experiences and sense of competence when using the Infant-Toddler Checklist (ITC) at the 18-month health visit. The nurses considered the ITC to be a beneficial tool both in communicating with families and in identifying children with communication difficulties. The ITC seemed to enhance nurses’ and parents’ awareness of the child’s communication.In study IV, the psychometric properties of the ITC were analysed using data on 679 children. A sensitivity of 86% and specificity of 59% were found. These measures improved when combining the ITC with the child health service nurses’ informal developmental surveillance. Study V explored parents’ perceptions of the intervention ComAlong Toddler, consisting of five group sessions and two individual home visits. The parental intervention focused on responsive communication, enhanced milieu teaching and augmentative and alternative communication. Qualitative content analysis showed that parents appreciated the intervention and used the strategies taught. Parents described benefits of the combination of home visits and group sessions with peer learning through video recorded home assignments.In conclusion, the thesis shows that the ITC can be implemented in the child health services as the method identifies children with communication difficulties and seems to have preventive capabilities. ComAlong Toddler may help parents to implement communication-enhancing strategies with their children. When universal interventions are delivered through the child health services, implementation and distribution need to be carefully planned and carried out so that they reach all children.
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