| 1. |
- Mattsson, Susanne, 1978-
(författare)
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Health-related Internet use and screening for emotional distress in people with cancer
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to investigate the preferences and incentives for using Internet-delivered support among people with cancer and to develop and test a generic questionnaire measuring health-related Internet use, the Health Online Support Questionnaire (HOSQ). Another aim was to examine the psychometric properties of the online-administered Hospital Anxiety and Depression Scale (HADS) and Visual Analogue Scale (VAS) regarding anxiety and depression in psychosocial screening among people with cancer, in comparisons with the longer instruments Montgomery Åsberg Depression Rating Scale – Self-report (MADRS-S) and the State Trait Anxiety Inventory – State (STAI-S).Study I was a correlational and descriptive study on the development and psychometric properties of the HOSQ. Study II was a cross-sectional and descriptive study on health related Internet use in patients with cancer. Study III was a cross-sectional and descriptive study examining preferences for psychological treatments. Study IV was a psychometric comparison study of two short instruments and two longer instruments measuring anxiety and depression.Findings from study I showed that the HOSQ might be a reliable and valid instrument for measuring the use of online support for people with health problems. Results ought to be replicated though in larger and other groups to confirm the results for different diagnoses. Findings from study II confirmed results from other studies showing that people with cancer turn to the Internet for informational support that enables them to influence their care and to stay in touch with friends and relatives. Demographical differences regarding the uptake of Internet-based support remains, which indicates a need for research on how to bridge this digital gap. In study III, we found that a large majority preferred psychological treatment face to face whereas Internet-based interventions were reported as the preferred choice by a minority. Findings from the content analysis suggest that Internet-based interventions have specific advantages that may facilitate help-seeking among some individuals and some disadvantages that may be perceived as barriers. Initiatives to increase treatment acceptability may benefit from addressing the advantages and disadvantages reported in this study. In study IV we found that the use of the short and ultrashort tools HADS and VAS identified anxiety and depression in patients with cancer with high accuracy in comparisons with the longer instruments.In conclusion, online screening with the HADS and VAS may be a suitable initial method to identify anxiety and depression in patients with cancer. There is still a large proportion of patients who lack the interest or eHealth literacy to use health-related support on the Internet. By learning more about the barriers, use and perception of eHealth and Internet-based interventions, adequate support may be offered.
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| 2. |
- Byrskog, Ulrika, 1970-
(författare)
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’Moving On’ and Transitional Bridges : Studies on migration, violence and wellbeing in encounters with Somali-born women and the maternity health care in Sweden
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- During the latest decade Somali-born women with experiences of long-lasting war followed by migration have increasingly encountered Swedish maternity care, where antenatal care midwives are assigned to ask questions about exposure to violence. The overall aim in this thesis was to gain deeper understanding of Somali-born women’s wellbeing and needs during the parallel transitions of migration to Sweden and childbearing, focusing on maternity healthcare encounters and violence. Data were obtained from medical records (paper I), qualitative interviews with Somali-born women (II, III) and Swedish antenatal care midwives (IV). Descriptive statistics and thematic analysis were used. Compared to pregnancies of Swedish-born women, Somali-born women’s pregnancies demonstrated later booking and less visits to antenatal care, more maternal morbidity but less psychiatric treatment, less medical pain relief during delivery and more emergency caesarean sections and small-for-gestational-age infants (I). Political violence with broken societal structures before migration contributed to up-rootedness, limited healthcare and absent state-based support to women subjected to violence, which reinforced reliance on social networks, own endurance and faith in Somalia (II). After migration, sources of wellbeing were a pragmatic “moving-on” approach including faith and motherhood, combined with social coherence. Lawful rights for women were appreciated but could concurrently risk creating power tensions in partner relationships. Generally, the Somali-born women associated the midwife more with providing medical care than with overall wellbeing or concerns about violence, but new societal resources were parallel incorporated with known resources (III). Midwives strived for woman-centered approaches beyond ethnicity and culture in care encounters, with language, social gaps and divergent views on violence as potential barriers in violence inquiry. Somali-born women’s strength and contentment were highlighted, and ongoing violence seldom encountered according to the midwives experiences (IV). Pragmatism including “moving on” combined with support from family and social networks, indicate capability to cope with violence and migration-related stress. However, this must be balanced against potential unspoken needs at individual level in care encounters.With trustful relationships, optimized interaction and networking with local Somali communities and across professions, the antenatal midwife can have a “bridging-function” in balancing between dual societies and contribute to healthy transitions in the new society.
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| 3. |
- Kalin, Torbjörn
(författare)
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Om upptäckt och sortering till social barnavård : Longitudinella perspektiv på barn som far allvarligt illa
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Att upptäcka barn som far illa är en uppgift för samhället. Merparten av världens länder har genom Barnkonventionen förbundit sig att ha effektiva system för att upptäcka barn som far illa. Det svenska systemet innebär att verksamheter som möter barn och föräldrar har en skyldighet att anmäla misstankar om barn som far illa till den sociala barnavården. Allmänheten uppmanas också att anmäla, och barn och familjer kan själva ansöka om stöd. Ambitionen bakom systemet är att de barn som är i störst behov av stöd och skydd ska upptäckas. Tidigare forskning har visat påtagliga skillnader i fråga om vilka barn som blir föremål för aktualiseringar och utredningar hos den sociala barnavården. Däremot saknas kunskap om skillnaderna kan förklaras utifrån skilda behov eller utifrån skilda föreställningar om behov, så kallad bias. Vidare saknas kunskap om det är samma barn som upplever sig fara illa som också aktualiseras och utreds.Det övergripande syftet med avhandlingen är att öka kunskapen om barn som far allvarligt illa, samt om dessa barn upptäcks och sorteras vidare till social barnavård. Fokus ligger på två områden. Dels vad som utmärker barn som far allvarligt illa, dels vad som bidrar till sorteringen av dessa barn, när de aktualiseras samt när de bedöms vara i behov av vidare utredning inom den sociala barnavården.Avhandlingen består av fyra empiriska studier baserade på data från det longitudinella forskningsprogrammet Longitudinal Research on Development to Young Adults (LoRDYA) som utgår från 1884 barn. Dessa rekryterades år 2013, vid 12 och 13 års ålder, i fyra små- och medelstora kommuner i Sverige. Metodologiskt tillämpas olika analytiska ansatser, såväl variabelcentrerade metoder som personcentrerade metoder. Genomgående används olika former av regressionsanalyser för att undersöka det unika bidraget av varje faktor kontrollerat för övriga faktorer.Resultaten visar att drygt vart fjärde barn någon gång under tonårstiden har självskattade tecken på att fara allvarligt illa. Detta trots att en mycket strikt definition av att fara allvarligt illa tillämpades. Barn med självskattade tecken på att fara allvarligt illa har mer kontakt med vanliga aktualiseringskällor, exempelvis polis, hälso- och sjukvård och elevhälsa, på grund av svårigheter än vad andra barn har. Drygt en femtedel av alla barn blir någon gång under tonårstiden aktualiserade till den sociala barnavården, men mindre än hälften av dessa aktualiserade har självskattade tecken på att fara allvarligt illa. Skillnaderna i vilka som blir aktualiserade kan främst förklaras av familjeförhållanden, där de förhållanden som utmärker sig är att ha en ensamstående förälder och att familjen lever i fattigdom. När aktualiseringar bedöms hos den sociala barnavården sorteras drygt en tredjedel av alla aktualiserade barn med självskattade tecken på att fara allvarligt illa ut. Flickors aktualiseringar blir i större utsträckning föremål för utredning än pojkars aktualiseringar. Sannolikheten för utredning ökar för flickors aktualiseringar om de har självskattade tecken på att fara allvarligt illa eller lever i fattigdom. När aktualiseringar handlar om pojkar minskar sannolikheten för utredning ju äldre pojken är eller om aktualiseringsskälen gäller beteendeproblem i kombination med försummelse. Tidigare aktualiseringar ökar utredningsbenägenheten i störst utsträckning oberoende av kön.Fynden diskuteras utifrån avhandlingens teoretiska ramverk. Slutsatsen är att systemet för att upptäcka barn som far illa har låg sensitivitet, eftersom många barn som far allvarligt illa sorteras ut. Systemet verkar därtill ha låg specificitet eftersom att leva med en ensamstående förälder eller ha knappa ekonomiska förhållanden verkar tolkas som faktiska indikatorer på att barnen far allvarligt illa, snarare än riskfaktorer, medan frånvaron av dessa förhållanden tvärtom tolkas som att barn inte far illa.
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| 4. |
- Nilsson, Åsa, 1967-
(författare)
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Towards a shared understanding : Exploring encounters in hospital care from the perspectives of nurses and patients
- 2017
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this licentiate thesis was to describe encounters in hospital care from the perspectives of nurses and patients. It focuses specifically on nurses’ views of shortcomings in patient-care encounters in one hospital (I) and the meanings of participation in hospital care as narrated by patients (II). Three focus group discussions with 15 registered nurses were conducted, and data were analyzed using thematic content analysis (I). Narrative interviews were conducted with 15 patients in hospital care, and the interviews were analyzed with a phenomenological hermeneutic interpretation (II). This licentiate thesis shows that a shared understanding is considered as central for both the nurses and the patients in the hospital-care encounter. The nurses demonstrate the need to understand, to create space, and also to be available for vulnerable patients. The patients describe the need to be understood and to understand their own situations. This thesis suggests that positive encounters in hospital care imply that nurses need to take responsibility for creating a mutual dialogue where the patient experiences himself or herself as a co-creator in a trustful context. When nurses acknowledge and confirm the vulnerability of their patients, it becomes possible to support them to participate in an active manner. A well-functioning team, as well as a coherent environment, is, in this thesis, understood as a precondition for positive hospitalcare encounters.
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| 5. |
- Olsson, Pernilla, Adjunkt, 1981-
(författare)
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Sfi-elevers investering i grundläggande skriftspråksutveckling på ett andraspråk : Litteracitetspraktiker i elevernas vardagsliv och i sfi-undervisningen
- 2024
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This licentiate thesis focuses on Sfi students (municipal adult education in Swedish for immigrants) with limited opportunities to participate in formal education prior to their immigration to Sweden, and their basic literacy development in Swedish as a second language. The overall aim of the research project is to identify experiences of literacy among the students, in their everyday lives as well as within the school setting, in order to explore how the students’ participation in different literacy practices provide a foundation for their investment in their own literacy development.Linguistic ethnography is employed as the overarching methodological approach, and the empirical data was produced through classroom observation, ethnographic shadowing and stimulated recall interviews. As a means of emphasizing the students’ perspectives on literacy and analyzing them in terms of investment, the emic approach has been particularly important.Drawing on examples of literacy events in the empirical data, literacy practices were analyzed. Understood in a broad sense, the concept of literacy here includes the use of a wide repertoire of semiotic resources, languages and technologies, as described within the field of New Literacy Studies (NLS, Barton, 2007). In addition to NLS, the theoretical frame used in the project was transliteracy (García, 2020; Canagarajah, 2013), critical literacy (Martin-Jones, 2007) and theory of investment (Norton, 2000; Darvin & Norton, 2021).The results show that the knowledge, experiences and needs of the students are often marginalized by a deficiency perspective on their abilities as well as an ethnocentric view of functional literacy. In their everyday lives, the students’ various communicative purposes required them to use a multifaceted repertoire of interrelated abilities, modalities and semiotic resources, which differ significantly from those emphasized and utilized in the classroom setting. Through theoretical perspectives on investment, a tension between the students’ agency, on the one hand, and the dominant institutional understanding of how written language should be used and developed, on the other hand, is thereby made visible (see Norton & Darwin 2015, 2020).
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| 6. |
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| 7. |
- Söderholm Werkö, Sophie, 1972-
(författare)
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Patient Patients? : Achieving Patient Empowerment through active participation, increased knowledge and organisation
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This study examines patient empowerment in two local diabetes branch organisations in Sweden. In particular, the study focuses on the organisations’ membership, participation and influence on external actors. The overall aim of this thesis is to explore patient empowerment in order to discern what influence patient organisations and individual members can have and how they use it. This study is based on both quantitative and qualitative empirical data. Interviews with active members from two local diabetes organisations were conducted and a survey was carried out to identify the members’ thoughts and feelings about their membership, motivations, participation and influence, as well as to examine their local organisation, its work and influence. The findings form an overall picture of how members experience their organisation, memberships and empowerment. Characteristics of the two local patient branch organisations were identified and the leaders were found to be intensely dedicated people. The interviews, survey and participant observations revealed the members’ opinions about their organisation, their reasons for joining, their involvement, participation and influence, as well as their understanding of the local organisation and the Swedish Diabetic Association (SDA) and their possibility to empower them. Without organisations, members felt that they could not have a significant influence on external actors and events.
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