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| 3. |
- Bergmark, Magnus, et al.
(författare)
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Evidence-based Methods in Rural Areas – Knowledge and National Guideline Utilization in Mental Health Service Development
- 2022
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Ingår i: Journal of Evidence-Based Social Work. - : Routledge. - 1543-3714 .- 1543-3722 .- 2640-8066 .- 2640-8074. ; 19:2, s. 161-184
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To examine how rural municipalities develop services to people with serious mental illness in relation to evidence-based practice and national guidelines. Additional sources of knowledge and strategies used by the municipalities in relation to their development needs were explored as well.METHOD: Qualitative multiple-case approach, with 43 deep-interviews involving 84 informants representing selected social psychiatric services from 11 sites.RESULTS: National guidelines and evidence-based practices have a limited impact on how rural municipalities develop services to the target group. The municipalities favor other sources of knowledge, including regional networks, pragmatic problem-solving approaches and community-based knowledge.DISCUSSION AND CONCLUSION: Most of the informants expressed a need for more systematic and evidence-based knowledge in order to meet their clients’ needs. A major challenge to improve the utilization of these methods, is to make adaptions to match the rural municipalities’ needs and actual resources without risking the quality of these evidence-based services.
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| 4. |
- Bostedt, Göran, 1956-, et al.
(författare)
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Unga och arbete : Strukturella faktorer och individuella lösningar i arbetsmarknadspolitiska projekt - En kunskapsöversikt
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Syftet med denna studie har varit att analysera effekterna av de olika ar-betsmarknadspolitiska insatser som gjorts i Västernorrland för unga. Som underlag till analys har erfarenheter från olika arbetsmarknadspolitiska insatser i såväl Sverige som helhet (sekundäranalyser av genomförda utvärderingar för Sverige som helhet) som i Västernorrland (primärana-lys av utvärderingar som gjorts av genomförda projekt) använts. Därtill har inläsning av relevant teoretisk litteratur gjorts i syfte att sätta in det empiriska materialet i ett sammanhang. I studien har de olika inventerade projektens problemfokus kontrasterats mot en analys av ungdomars ut-satthet idag. Vi har intresserat oss för om problemfokus har utgjort en relevant översättning/förståelse av ungdomars behov idag.Studiens målgrupp har varit ungdomar i åldern 16-24 år. En mycket vik-tig och central del av vår studie har varit att inventera olika arbetsmark-nadspolitiska projekt som genomförts för ungdomar i Västernorrland åren 2007-2012 och analysera upplägg och resultat av dessa projekt. In-venteringen har medfört behov av olika typer av avgränsningar. Det em-piriska underlaget kan därför mer karaktäriseras som ett urval av det to-tala antalet projekt i länet än en total sammanställning.Studiens slutsatser kan sammanfattas i följande punkter: Ett allt för stort fokus på individ kan medföra att de struktu-rella hindren glöms bort. Ett medicinskt perspektiv vid arbetsmarknadsåtgärder för-stärker fokus på individens beteenden och brister, d.v.s. att arbetslöshet riskerar att medikaliseras. Tillstånd eller process? Utanförskap framställs ofta som ett individuellt tillstånd där åtgärderna framförallt inriktas mot individen. Vi ställer frågan om inte andra begrepp, som t.ex. marginalisering, social exkludering eller etablering, kan lyfta fram en process där strukturella hinder får större fokus? Ett utvidgat problemfokus kan leda till nya former av sam-verkan med fler aktörer och alternativa arbetssätt. Socialt kapital utgör en viktig del av problemlösning. Ung-domarna själva, men även litteraturen, har tagit upp bris-tande socialt kapital, oftast en brist av kontakter, som ett av de största hindren att etablera sig i arbetslivet. Samverkan är något viktigt och betydelsefullt. Vid samver-kan behöver dock helhetsperspektivet förstärkas i förhål-lande till en sektoriserad specialisering. Samtidigt som vi menar att samverkan är viktigt, är det inte ensamt tillräckligt. Samverkan som kortsiktig lösning av ungdomars sammansatta behov får inte utesluta funderingar kring behov av institutionell förnyelse.
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- Dahlqvist Jönsson, Patrik, 1974-, et al.
(författare)
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Service users' experiences of participation in decision making in mental health services
- 2015
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Ingår i: Journal of Psychiatric and Mental Health Nursing. - Chichester : Wiley-Blackwell. - 1351-0126 .- 1365-2850. ; 22:9, s. 688-697
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Tidskriftsartikel (refereegranskat)abstract
- Service user participation in decision making is considered an essential component of recovery-oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core category that emerged in the analysis described a 'struggle to be perceived as a competent and equal person' while three related categories including being the underdog, being controlled and being omitted described the difficulties of participating in decisions. The data analysis resulted in a model that describes internal and external conditions that influence the promotion of participation in decision making. The findings offer new insights from a user perspective and these can be utilized to develop and investigate concrete methods in order to promote user's participation in decisions.
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| 6. |
- Dalin, Rolf, 1949-, et al.
(författare)
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An approach to measurement and statistical description of participation in community life for people with psychiatric disabilities
- 2010
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Ingår i: Scandinavian Journal of Disability Research. - : Stockholm University Press. - 1501-7419 .- 1745-3011. ; 12:1, s. 47-58
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Tidskriftsartikel (refereegranskat)abstract
- Participation has emerged as a central concept in defining the goals of disability policy in Sweden as well as internationally. Yet it has rarely been operationalized as a foundation for planning services. As part of an attempt to survey the needs of individuals experiencing psychiatric disabilities, the authors have developed a scale for measuring participation in five areas of community life. The scale uses four distinct categories as levels, specific for each area of life, and a set of statistical descriptive techniques designed to illustrate and communicate information regarding levels, capacities, and wishes related to a participatory life in the community. Based on a pilot study, the article illustrates how the collective needs of a population of individuals experiencing psychiatric disability can be described and presented to practitioners as a support for system planning.
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| 7. |
- Grim, Katarina, et al.
(författare)
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Development- and usability testing of a web-based decision support for users and health professionals in psychiatric services
- 2017
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Ingår i: Psychiatric rehabilitation journal. - Washington, DC : American Psychological Association (APA). - 1095-158X .- 1559-3126. ; 40:3, s. 293-302
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Shared decision making (SMD) related to treatment and rehabilitation is considered a central component in recovery-oriented practice. Although decision aids are regarded as an essential component for successfully implementing SDM, these aids are often lacking within psychiatric services. The aim of this study was to use a participatory design to facilitate the development of a user-generated, web-based decision aid for individuals receiving psychiatric services. The results of this effort as well as the lessons learned during the development and usability processes are reported. Method: The participatory design included 4 iterative cycles of development. Various qualitative methods for data collection were used with potential end users participating as informants in focus group and individual interviews and as usability and pilot testers. Results: Interviewing and testing identified usability problems that then led to refinements and making the subsequent prototypes increasingly user-friendly and relevant. In each phase of the process, feedback from potential end-users provided guidance in developing the formation of the web-based decision aid that strengthens the position of users by integrating access to information regarding alternative supports, interactivity between staff and users, and user preferences as a continual focus in the tool. Conclusions and Implications for Practice: This web-based decision aid has the potential to strengthen service users’ experience of self-efficacy and control as well as provide staff access to user knowledge and preferences. Studies employing participatory models focusing on usability have potential to significantly contribute to the development and implementation of tools that reflect user perspectives.
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| 8. |
- Grim, Katarina, et al.
(författare)
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Exploring psychiatric users’ decisional and information needs in Shared Decision Making in the light of Elwyn´s three-step model for Clinical practice
- 2015
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Ingår i: Closing the gap between research and policy in mental health. - Málaga : ENMESH. - 9788460827818 ; , s. 118-119
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Konferensbidrag (refereegranskat)abstract
- Introduction: Using medication and participating in psychosocial interventions are active processes that often involve complex decision-making. Shared decision making, SDM, provides a model for user and practitioner to cooperatively assess a treatment’s advantages and disadvantages. Decision aid tools adapted to the needs of users have the potential to restructure how people with mental illness and staff work together to arrive at shared decisions about the next steps in treatment or support.Aims: The objective of this study is to investigate decisional and information needs among users with mental illness as a pre-requisite for the design and development of a decision aid aimed at supporting user participation in SDM.Methods: Needs and preferences regarding information transfer in SDM were explored through semi-structured focus group interviews. Participants were adults with psychiatric diagnoses and experience of psychiatric services or close relatives to someone with a psychiatric illness.Qualitative content analysis was used to analyze the data. The transcriptions were initially analyzed in accordance with a conventional, inductive approach. A directed content analysis was then utilized, with Elwyn’s three step model for SDM as a theoretical framework from which to further operationalize the categories rendered in the first step of analysis.Results: The majority of the findings were easily integrated within Elwyn ́s categories. However, some elements which emerged in the data and which are worth noting were not encompassed within Elwyn’s model, such as the wish for information prior to the meeting regarding the time frame and agenda. The importance of heeding the prior knowledge of the user as valuable for the decision process and not solely checking it in order to correct possible misinformation was frequently expressed, as was the value of follow-ups.Conclusions: Even though Elwyn’s model is constructed as a pedagogic tool to be used by staff, while our focus is directed towards creating a tool for users, the application of the model upon our data was indeed helpful in rendering clearly defined and distinguishable codes from our categories. We therefore consider it to be a suitable model to continue to build upon in the development of a decision aid.
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| 9. |
- Grim, Katarina, 1971-, et al.
(författare)
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Legitimizing user knowledge in mental health services : Epistemic (in)justice and barriers to knowledge integration
- 2022
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Ingår i: Frontiers in Psychiatry. - Lausanne : Frontiers Media S.A.. - 1664-0640. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Including the voices and knowledge of service users is essential for developing recovery-oriented and evidence-based mental health services. Recent studies have however, suggested that challenges remain to the legitimization of user knowledge in practice. To further explore such challenges, a co-production study was conducted by a team of researchers and representatives from user organizations in Sweden. The aim of the study was to explore the barriers and facilitators to the legitimacy of user knowledge, as a central factor in sustainably implementing user influence in mental health practice. A series of workshops, with representatives of mental health services and user organizations were conducted by the research team to explore these issues. The analysis built on the theoretical framework of epistemic injustice, and the underlying aspects, testimonial, hermeneutic and participation-based injustice, were utilized as a framework for a deductive analysis. Results suggest that this is a useful model for exploring the complex dynamics related to the legitimacy of user knowledge in mental health systems. The analysis suggests that the legitimacy of user knowledge is related to the representativeness of the knowledge base, the systematic formulation of this knowledge inapplicable methods, access to resources and positions within the mental health system and participation in the process of integrating this knowledge-base in mental health contexts. Legitimizing user knowledge in practice additionally challenges mental health systems to support readiness for change in working environments and to address the power and role issues that these changes involve. Copyright © 2022 Grim, Näslund, Allaskog, Andersson, Argentzell, Broström, Jenneteg, Jansson, Schön, Svedberg, Svensson, Wåhlstedt and Rosenberg.
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| 10. |
- Grim, Katarina, 1971-, et al.
(författare)
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Managing Peer Support Workers in Swedish Mental Health Services : A Leadership Perspective on Implementation and Sustainability
- 2023
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Ingår i: Journal of Psychosocial Rehabilitation and Mental Health. - : Springer. - 2198-9834 .- 2198-963X. ; 10:3, s. 313-329
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Tidskriftsartikel (refereegranskat)abstract
- Even though it has been demonstrated that peer support contributes to positive outcomes for service users, organizational implementation issues remain. The aim of the current study was to examine an implementation of peer support from the perspective of managers in order to develop knowledge of factors influencing sustainability of this initiative. Eighteen managers were interviewed in connection with the introduction of peer support in sixteen mental health settings. Interviews were analyzed utilizing inductive and deductive approaches. The results suggested that managers were predominantly positive in their evaluation of peer support as a recovery-oriented addition to their services, but noted developmental issues regarding role, professional identity, supervision and financing in relation to other traditional personnel. The involvement of the user movement, especially with regard to training and supervision helped prepare staff and support peer workers, yet there was some apprehension attached to the critical scrutiny that this `outsider’ perspective might imply. The results confirm previously noted uncertainties regarding peer support as an integrated component of mental health systems and illuminate a number of culturally conditioned challenges that may hamper peer support from being implemented with the same approach as other interventions. In response, the present study suggests a number of focus areas that should be attended to in future implementation efforts, including issues related to staff roles, power dynamics, connection to the user movement and reconsideration of the value of experience-based knowledge. In the Swedish context, a government level commitment was identified as critical to ensure stable funding.
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