| 1. |
- Fischl, Caroline, 1974-
(författare)
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Ageing in a digital society : an occupational perspective on social participation
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: For older adults to continue being healthy and active participants in an evolving digitalized society, there is a need to support their social participation through engagement in occupations that they need, want, or are expected to do in accordance to the roles that they assume. Occupational therapists together with other professionals face emerging challenges to promote older adults’ engagement in occupations mediated by digital technology. It is therefore relevant to acquire an understanding about how older adults continue to participate in their daily lives and engage in the occupations within their particular contexts. It is also relevant to explore ways to tailor supports for engaging in contemporary occupations and to measure the outcomes of such supports. Aim: The overall aim of this thesis was to develop knowledge to support older adults’ social participation through engagement in occupations mediated by digital technology. Developing knowledge entailed an exploration of older adults’ engagement in occupations mediated by digital technology (Study I), their contexts surrounding social participation (Study II), and tailoring supports for engagement (Study III). Additionally, part of developing knowledge also entailed an investigation of how outcomes of tailoring – specifically ability to perform occupation mediated by digital technology and ability to manage technology – could be measured and related (Study IV).Methods: Study participants were selected from rural and urban municipalities in Northern Sweden. In Study I, data was gathered through concurrent think aloud protocol and observations of ten older adults, aged 66-79 years, while they engaged in occupations that involved digital technology. Narrative inquiry was used to illuminate features in their occupational engagement and participation in daily life. In Study II, focus group interviews of eighteen older adults, aged 66-81 years, were conducted and analyzed using qualitative content analysis. Study III used a multiple case study methodology that included nine cases. Each case involved one adult who participated in a collaborative process to tailor supports for engagement in occupations mediated by digital technology. Data was gathered through questionnaires, observations, fieldnotes, memos for tailoring, and interviews, and then analyzed through cross-case synthesis. Nine older adults, aged 74-95 years, participated. In Study IV, twenty-five older adults, aged 71-93 years, were observed in their performances of digital technology-mediated occupations and scored on the Assessment of Computer-Related Skills and the Management of Everyday Technology Assessment. Data was analyzed using Rasch analysis and Spearman correlation test. Results: Findings in Study I were presented as three stories reflecting facets of participation – Being alone, Belonging together, and Being alone together. The stories illuminated older adults’ participation involving digital technology as a negotiation of needs and values, refinement of identities, and experience of meaning during interactions with technological and social environments. Findings in Study II were sorted in three categories – Experiencing conditions for social participation in a state of flux, Perceiving drawbacks of urbanization on social participation, and Welcoming digital technology that facilitates daily and community living – and encapsulated in the theme The juxtaposition of narrowing offline social networks and expanding digital opportunities for social participation. The findings suggested that facilitating satisfactory use of digital technologies and co-creating usable digitalized services could support older adults’ social participation through occupations that they find relevant in their lives, and subsequently, might enable them to live longer at home. Study III resulted in a proposed scheme for tailoring to support older adults’ engagement in digital technology-mediated occupations. The scheme included various intervention strategies tailored to persons in their contexts, such as adapting visual settings on the device and forming instructional materials based on the older adults' needs and preferences. Tailoring interventions require collaboration with other professionals. Results in Study IV indicated preliminary evidence of internal validity and reliability in two aforementioned instruments on a small sample of older adults. Results also showed that there is a significant and strong positive correlation between the ability to engage in digital technology-mediated occupations and the ability to manage digital technology. It implies that an older person who is more able to engage in digital technology-mediated occupations will likely have more ability to manage digital technology and vice versa. In the same manner, an older person who is less able to engage in digital technology-mediated occupations will likely have less ability to manage digital technology and vice versa.Conclusions: In the contexts of ageing, narrowing social networks, and expanding digital possibilities, participation through satisfactory digital technology use can provide older adults opportunities to continue being active members of society. A scheme has been proposed to tailor supports for older adults’ occupational engagement, which needs further testing in various practice settings. Instruments for measuring outcomes of tailored supports have also been identified but need further validation in studies with older people.
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| 2. |
- Jönsson, Marie, 1966-
(författare)
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Everyday activities in older adults readmitted to hospital
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The coordination of health care and social care at discharge are particularly important for older adults with complex health and social needs, as approximately 30 % of these persons are readmitted to hospital on an unplanned basis within three months of discharge. In order to provide adequate care for this group of older adults, we need a deeper understanding of their experiences regarding their functional ability at hospital and at home.The overall aim of this thesis was to describe older readmitted adults in terms of their abilities at hospital, everyday activities at home and of healthcare professionals’ conception of the care of older adults. Four studies were conducted using descriptive design. Data were gathered using four different methods of data collection. In this thesis, older readmitted adults are, defined as persons aged 75 years or older who have been readmitted to hospital on an unplanned basis three or more times within 12 months. In Study I, older adults readmitted to hospital (n=60), were assessed regarding personal activities of daily living, cognitive function, risk of falls, pressure sores and malnutrition. They were compared with samples from the general population. In order to describe everyday activities at home, semi-structured interviews were carried out with older readmitted adults (n=16) in Study II, and with close relatives (n=20) in Study III. In Study IV, focus group interviews were performed with healthcare professionals (n=29) about care at discharge and which measures that may be appropriate in order to prevent readmission.The major findings were that the participants had a higher risk of pressure sores, falls and dependency on ADL at hospital compared to age-matched samples. 40% of the participants had a cognitive limitation. At home, older adults strived to perform everyday activities but the ability was limited. Close relatives described that social relations were fundamental to perform everyday activities and social activities at home. Healthcare professionals stated that older readmitted adults were vulnerable. Multidisciplinary teamwork and geriatric expertise were fundamental but were perceived as lacking. Medical resources and rehabilitation resources should be developed and include rapid follow-up appointments at home in order to prevent readmission.Overall, health care and social care must identify this group and offer preventive assessments and interventions.
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| 3. |
- Nilsson, Ingeborg, 1969-
(författare)
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Occupational Engagement among Older People : Evaluation, Repertoire and Relation to Life satisfaction
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Occupational engagement among older people is important to investigate as older people are the fastest growing segment in our society, and because occupational engagement is viewed within occupational therapy as one of the basic premises for health. Three perspectives of engagement are highlighted in this thesis: evaluation of occupational engagement, the repertoire of occupational engagement, and finally, the relation between occupational engagement and life satisfaction. The overall aim of this thesis was to study aspects of occupational engagement among older people, with a special focus on evaluation of the experiences of an occupation-based group programme, evaluation of leisure, the leisure repertoire, and the relation between occupational engagement and life satisfaction. The thesis is comprised of four studies which all contribute in different ways to an increasing understanding of occupational engagement among older people. In the first study (Study I), three older persons participated in a group activity programme and were interviewed about their experiences of occupational engagement. The qualitative interviews were done with each participant after each group session, in total 15 interviews. The other three studies (Studies II-IV) were based on a subgroup of a population studied in a cross-sectional population-based study, the Umeå 85+ study. Very old people with an MMSE score of 20 or more were included in Studies II, III, and IV (n=156). During home visits, they were interviewed about their occupational engagement (ADL and leisure) and their life satisfaction. The qualitative interviews analysed using a Grounded theory approach, revealed two different dimensions of experiences while engaged in a group programme. The participants described experiences of activation, with a creative force and a place for learning, but also experiences of transformation with reflection, adaptation, and finally, a personal synthesis. Evaluation of occupational engagement through measurement using the modified NPS Interest Checklist (MNPS) was made possible using Rasch analysis. The results revealed preliminary evidence for internal scale validity and person response validity. Scale and person reliability were Rasch equivalents of Cronbach alpha of .98 for items and .66 to .75 for persons, respectively. In their leisure repertoire, very old people were more likely to endorse Social and Cultural activities and least likely to endorse Ballgames and Equipment sport. Traditional gender differences and some differences between older persons in rural versus urban areas and between persons with different cognitive levels were also found. Finally, significant correlations were found between life satisfaction and both engagement in ADL (r =.31) and engagement in leisure (r =.34) among very old people. A forced entry regression revealed that both variables together explained slightly more (12.4%) than leisure alone (11.2%). As a conclusion and in relation to evaluation of occupational engagement during therapy, the experiences of engagement are described by the respondents from both a perspective of action and a perspective of inner reflection, and together they might support the developmental process among older people. Through using Rasch analysis, it was possible to convert ordinal data into linear measures and also to organize leisure occupations into a hierarchical repertoire of engagement. This repertoire gives further understanding for specific tasks and about the general relation between leisure dimensions. Finally, the contribution of occupational engagement to life satisfaction is likely essential, but explains only about 12% of total life satisfaction among very old people.
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| 4. |
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| 5. |
- Yngve, Moa, 1985-
(författare)
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Participation and ICT : Students with Special Educational Needs in Upper Secondary School
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: The use of information and communication technology (ICT) has been highlighted over the past 20 years as a promising accommodation to improve participation in school activities among students with special educational needs (SEN). However, evidence is still needed. In addition, little attention has been given to students opportunities for participation in school activities, their need for and access to support in school activities among students with SEN in upper secondary education. Aim: The overall aim of this thesis was to increase knowledge about the participation in school activities of students with special educational needs in regular upper secondary education before and after they received an ICT intervention, and subsequently their participation in productive occupations. Methods: This thesis comprises four studies in which secondary data from a sample of students with SEN in upper secondary education that had received an ICT intervention was used. Secondary data of students was retrieved from two intervention projects in which school personnel identified students with SEN based on the following criteria: difficulties in achieving educational goals, or completing school assignments and/or high levels of school absence. The first study included secondary data for 509 students with SEN who had given written informed consent to participate in the research. Of these, about forty percent did not have any educational support at inclusion. Based on the pool of 509 students, study-specific criteria was applied in three successive studies. Study I was a psychometric evaluation of the assessment instrument the School Setting Interview (SSI), which measures the student–environment fit and identifies students’ potential need for support in 16 school activities. Rasch analysis was used to examine the targeting, model fit, functioning of items and response categories, and unidimensionality of the SSI scale. Study II used descriptive statistics to examine the perceived need for, and access to, support in school activities among 484 students. In addition, a logistic regression analysis was applied to identify factors associated with students who perceived a need for support in school activities to the highest extent.In study III, the influence of an individualised ICT intervention on participation in school activities was evaluated among 300 students with SEN. Descriptive statistics were used to analyse students SSI assessments before and after the intervention, their school attendance, and pass grades. A Wilcoxon’s signed-rank test and a t-test investigated differences in support needs and the interval measure of student–environment fit, generated via Rasch analysis, before and after the ICT intervention. Chi-square analyses and t-tests were performed to investigate differences between students who had and had not achieved a significant improvement in student–environment fit after the intervention.Study IV applied an embedded mixed-methods approach. Participants who had agreed during study III to be contacted one year after upper secondary education (n = 244) received a questionnaire to investigate their participation in productive occupations. Eighty-one answered the questionnaire. In addition, 20 participated in a semi-structured interview using the Swedish version of the Worker Role Interview (WRI) to investigate their perceived work ability. Data from the questionnaire and the participants’ WRI ratings were analysed using descriptive statistics, and group comparisons were performed between participants who were and were not established in productive occupations. Written notes from the WRI rating forms were analysed using a deductive content analysis. Findings: The students with SEN perceived a need for support in several school activities (Mdn 7) and were rarely satisfied with the support that the school had provided (study II). It was demonstrated that the academic school activities: Remember things, Write, Do homework, Read and Take exams, in which more than two-thirds of the students perceived a need for support, were in need of most improvements to promote students’ participation. Study II further showed that students with a high level of school absence, enrolled in a vocational programme or with a neuropsychiatric disorder were those who perceived the greatest need for support in school activities.The psychometric evaluation of the SSI in study I provided support for the construct validity of the SSI for measuring the student–environment fit among students with SEN in upper secondary education. Furthermore, the analysis revealed that the rating categories of the scale did not function as intended which led to a post hoc categorisation of items with disordered thresholds in Study III in order to obtain reliable measurements of student– environment fit before and after the ICT intervention.Study III showed that an individualised ICT intervention, including computer, tablet and/or smartphone with software, and services to use the ICT as support in school activities, increased the student–environment fit. After the intervention, the decrease in students’ support needs and improved student–environment fit were found to be statistically significant with large effect sizes. Just over half of the students had increased or maintained their school attendance and obtained pass grades in all the courses in which they were enrolled in English, Mathematics and Swedish. The ICT intervention proved to be most beneficial for students who experienced fewer than the median number of support needs in school activities (Mdn 6), who had been without previous support in school and for students with pass grades.One year after upper secondary education, almost two-thirds (63%) of the participating 81 former students with SEN were either working or enrolled in further studies. The group that was established in work or further studies had obtained pass grades in all subjects to a greater extent and had received time-assisting ICT to a lesser extent during the intervention in their upper secondary education than the group that was not established (study IV). The former students with SEN believed in their work ability and were optimistic and motivated about future work or studies. During the process of finding and obtaining a productive role as an employee or student, the participants perceived social support from friends and family. Conclusion: This thesis demonstrated restricted participation in several school activities among the students with SEN in upper secondary education and students were rarely satisfied with the support that the school had provided. Findings indicated that the academic school activities: Remember things, Write, Do homework, Read and Take exams were in need of most improvements to promote participation among students with SEN. Attention should also be given to identifying the need for support in school activities among students with a high level of school absence, enrolled in vocational programmes or with a neuropsychiatric disorder. In this process, the SSI can be used as a valid assessment instrument. An individualised ICT intervention has the potential to provide students with SEN better opportunities to participate in school activities. Findings also indicated that the former upper secondary school students with SEN who had received an individualised ICT intervention had belief in their work ability.
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| 6. |
- Zingmark, Magnus, 1971-
(författare)
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Occupation-focused and occupation-based interventions for community-dwelling older people : Intervention effects in relation to facets of occupational engagement and cost effectiveness
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background Occupation-focused and occupation-based interventions can potentially promote occupational engagement among community-dwelling older people, but there is limited evidence to identify the most effective and cost-effective interventions. For independent-living older people, there is a lack of evidence to determine if occupation-focused and occupation-based interventions have an effect on their occupational engagement. For older people who need assistance because of bathing disabilities, there is limited evidence of the effects of occupation-focused and occupation-based interventions on their occupational engagement or for reducing or omitting their need for assistance. Finally, there is limited evidence to determine if occupation-focused and occupation-based interventions implemented for community-dwelling older people are cost effective.AimThe aim of this thesis was to evaluate the effects and cost effectiveness of occupation-focused and occupation-based interventions for two groups of community-dwelling older people, independent-living, community-dwelling older people and older people with bathing disabilities.MethodStudies I and II were based on an exploratory randomized controlled trial. One hundred and seventy seven persons, 77–82 years, single living, and without need for home help were randomized to a no-intervention control group or to one of three occupational therapy interventions focused on promoting occupational engagement: an individual intervention, an activity group or a discussion group. In study I, effect sizes for leisure engagement and ability to perform activities of daily living (ADL) tasks were estimated for each intervention in relation to the control group to identify the most effective intervention at 3 and 12 months after baseline. In study II, the effects on quality adjusted life years (QALYs) and the total costs for the intervention, social services provided by the municipality and health care were used evaluate cost-effectiveness.Study III was a quasi-experimental clinical trial and included 95 persons, 65+, who had applied for municipality-based home help with bathing. For participants in the intervention group, occupational therapists implemented occupation-focused and occupation-based interventions. No occupational therapy intervention was implemented for those in the control group, but they were allocated home help services if judged to need it based on an assessment by a municipality care manager. Evaluations of ADL ability, self-rated health and allocated home help were implemented at baseline and after 15 weeks.Study IV involved the use of decision-modeling based on a five state Markov model that included levels of dependency in ADLs, place of residency and death. Probabilities for transitions between states in the model, QoL scores and societal costs for each state were derived from previous research. Overall, the model was based on research indicating that more severe levels of dependency reduced QALY scores and increased societal costs. Previous trials have provided evidence that an occupation-focused and occupation-based intervention implemented to reduce bathing disabilities increased the probability of independence of home help. The Markov model was used to evaluate cost-effectiveness over 8 years for an intervention compared to no intervention.ResultsThe results of study I indicated that each intervention had a small positive effect on minimizing a decline in leisure engagement and/or ADL, but no intervention was clearly superior. In study II, the results indicated that the interventions delivered in a group format positively affected self-rated health. The discussion group was the most cost-effective intervention. The results of study III indicated that the intervention had no effect on ADL ability or self-rated health. There was, however, a large difference in the allocation of home help at follow up, indicating that the intervention was effective in reducing dependency on home help for bathing. The results of study IV indicated that compared to no intervention, the intervention resulted in a positive accumulation of QALYs and lower costs for every year during the entire 8 year period.ConclusionThis thesis provides evidence to support the implementation of occupation-focused and occupation-based interventions for independent-living, community-dwelling older people in order to reduce their decline in occupational engagement and improve their self-rated health; the interventions also have the potential to be cost effective. This thesis also provides evidence that an occupation-focused and occupation-based intervention implemented for older people with bathing disabilities was effective in promoting independence from home help for bathing. Finally, an occupation-focused and occupation-based intervention that increased the probability of being independent of home help for bathing had a positive impact on the long term accumulation of QALYs and reduced societal costs and, therefore, can be considered very cost effective.
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| 7. |
- Bergström, Aileen, et al.
(författare)
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Phronesis: Recognising a neglected dimension of knowledge within occupational therapy research
- 2024
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Taylor & Francis Group. - 1103-8128 .- 1651-2014. ; 31:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Phronesis is a way of knowing, implying wisdom, experiences, and reflections that guide our judgements. Phronesis, important for learning, is a neglected form of knowledge when applied to research.Aim: To examine how phronesis is conceptualised and practiced in three research projects.Method: Data from eight interviews with researchers involved in three research projects was generated. The interview material was analysed. A theoretical matrix of contemporary understanding of phronesis was applied to the material.Result: Examples of phronesis from three research projects in occupational therapy are presented according to categories of contemporary phronesis; acknowledging embodiment, embracing humility, using perceptiveness, and practicing reflexivity.Significance: This unique approach of analysing research projects contributes to the understanding of phronesis and its implications for research, providing valuable insights into the researchers’ praxis in their respective projectsConclusion: There is a need for a greater recognition of phronesis as a dimension of knowledge within all types of research, and within the discipline. By not recognising phronesis as a legitimate form of knowledge, the discipline perpetuates a superiority of knowledge from episteme that dominates our ways of learning about the world around us and where the type of knowledge gleaned from phronesis is consequently marginalised.
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| 8. |
- Blusi, Madeleine, 1968-, et al.
(författare)
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Factors to consider when introducing digital social activities to older persons with home care
- 2023
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Ingår i: Caring is sharing. - : IOS Press. - 9781643683881 - 9781643683898 ; , s. 453-457
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Konferensbidrag (refereegranskat)abstract
- Social isolation and loneliness have become everyday concerns forpopulations all over the world as these factors are affecting both physical and mentalhealth in a negative way. Feelings of isolation and loneliness are increasinglyacknowledged as a health risk among older persons. ICTs have been recognized aseffective tools to combat social isolation among older people. The aim of this studywas to explore factors of significance when introducing a tablet-based systemproviding digital social activities for older persons with home care. Participants were17 persons, age 70 and older, who lived alone and had assistance from home care.This exploratory study used cross-sectional qualitative data analyzed throughthematic analysis. Three themes were generated: 1) lacking vocabulary related tothe context, 2) intuitive user interface may replace extensive instructions and 3)unwillingness to commit to a pre-defined measure of performance.
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| 9. |
- Larsson, Ellinor, 1982-
(författare)
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Promoting social activities and participation among seniors : exploring and evaluating social and Internet-based occupational therapy interventions
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- IntroductionThe use of technology and Internet-based activities (IBAs) is increasing in society. However, seniors with limited experiences with the Internet can experience restricted participation in meaningful activities that are dependent on the Internet. Also, social transitions during aging might lead to reduced social activities and social contacts and to increased experiences of loneliness, all of which might have negative health implications. Therefore, there is a need to advance the knowledge of how occupational therapists can support seniors’ use of IBAs and create opportunities for social contacts and social activities during aging.AimThe overall aim of this thesis is to increase the knowledge of how Internet-based activities influence seniors’ participation in society, how seniors experience and are influenced by support from a social Internet-based occupational therapy intervention, and how different aspects of this intervention can contribute to healthy ageing.MethodsIn study I, seniors’ experiences of IBAs were explored and described through interviews with 10 seniors (66–82 years old) that were analyzed with the constant comparative method. In study II, a multiple case study with five seniors (65–85 years old) was used to explore the design of an Internet-based occupational therapy social intervention program and how it influenced social activities and social contacts among the participants. The qualitative and quantitative data from multiple sources were analyzed by pattern matching. In study III, an explorative randomized crossover study with an AB/BA design was conducted with 30 seniors (61–89 years old) who were vulnerable to loneliness and who participated in the intervention program. The quantitative data were analyzed with parametric and non-parametric statistics. In study IV, a qualitative interview study was conducted to collect the experiences of 15 seniors (66–87 years old) from the previous intervention process in study III. The interviews were analyzed with the constant comparative method. All participants in studies I–IV were community-dwelling, retired seniors without home-care services. ResultsComplex interactions of different aspects influence seniors’ possibilities and preferences for taking part in IBAs. The performance of IBAs yielded different experiences of participation in society (study I). The initial explorative results indicated that the client-centered and individually adapted intervention program supports participation in social IBAs (SIBAs) and other social contexts (study II). After participation in the intervention program, the experiences of loneliness significantly decreased, and satisfaction with social contacts on the Internet increased for one group (study III). If an individual’s requirements are met during the intervention process, experiences of habitual SIBA usage, increased self-reliance, and enriched social contacts and social activities both on and off the Internet might be facilitated (study IV).ConclusionThis thesis provides knowledge of how social support, experiences of and accessibility to technology, life-changing events, and identified meaningfulness with online activities influence the motivation to participate in social and Internet-based activities. The occupational therapist should address the individual’s perspective in the intervention program so as to adapt the intervention and to support experiences of satisfactory participation and enhanced social activities and social contacts for seniors. In addition, healthy aging might be supported by the intervention program due to the reduction in loneliness and increased participation in social activities and society. Further evaluation of the framework and content of the intervention program for seniors with restricted participation in IBAs and SIBAs and high levels of loneliness is suggested.
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| 10. |
- Lindberg, Jens, 1980-
(författare)
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Orsak: Våldtäkt : om våldtagna män i medicinsk praktik
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Within the Swedish healthcare system, the care of raped men varies and many hospitals lack specific programmes. The aim of the thesis is to describe and analyse how meanings about rape and raped men are produced within Swedish healthcare. The central question is how different patient positions and conceptions about the phenomenon of male rape are created through care practices and how, in turn, that affects the care of raped men.The empirical material consists of interviews with healthcare professionals who have worked with raped men, field notes from participant observations and materials such as legislation, care protocols and medical records. In order to analyse how rape and raped men are articulated in practice and to highlight the norms that govern health- and rape care, the material has been analysed from a poststructuralist ‘logics’ perspective.The analysis departs from a number of healthcare settings – two emergency departments, one gynaecological department, one rape clinic, one health crisis recovery unit and a regional healthcare project developing new procedures for the care of raped women, children and men – and their work with predominantly male rape.One of the central aspects of the thesis is that it demonstrates that the care of raped men in many places lack clear procedures and that, consequently, health professionals either draw on ill-suited general care practices or make up new ones as they go. Norms about gender, sexuality, masculinity, rape and patienthood, but also organizational aspects and aspects of professional identity, greatly influence how raped men are treated.In the thesis it is also suggested that rape care is governed by a ’logic of need’. The logic of need is a logic that care professionals and settings need to follow to produce good healthcare, and which emphasizes and recreates differences between how the rape of women and the rape of men are understood. At the same time there are care practices that seek to create equivalences between the rape of men and the rape of women. These alternative articulations of rape care are both in line with, and in some ways challenging, dominant rape care. In doing so they have an impact on what is considered good care for raped men.Above all, the logic of need enables the articulation of established notions of raped men and healthcare’s long-standing preoccupation with good corporeal healthcare. The logic constructs male rape as a specific phenomenon and organises healthcare in such ways that create sometimes unequal health conditions for male victims. The logic limits raped men’s access to certain care practices and in many cases fails to offer raped men an established patient position. This in turn seems to limit the emergence of specially adapted care for that group of patients.
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