| 1. |
- Andersson, Catrine, et al.
(författare)
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Using Twelve-Step Treatment for Sex Addiction and Compulsive Sexual Behaviour (Disorder) : A Systematic Review of the Literature
- 2024
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Ingår i: Sexual Health & Compulsivity. - : Routledge. - 2692-9953.
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study is to explore the current scientific evidence for using the twelve-step method as a treatment method for sex addiction and compulsive sexual behavior (disorder). Peer-reviewed empirical articles on the twelve-step method and sex addiction and compulsive sexual behavior (disorder) written in English, Danish, Norwegian, or Swedish, retrievable in selected databases were included. No limits were set on publication date or study design. The systematic review resulted in eight empirical studies which were read and assessed according to the Mixed Methods Appraisal Tool. The results were inconclusive, and we found only three articles of high quality, where the samples were composed mainly by men, which indicate that peer-therapy in combination with individual therapy might be beneficial. That twelve-step treatment rests heavily on the idea of sex addiction was unproblematized in most of the publications. Overall, the findings raise issues concerning who benefits from this treatment.
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| 2. |
- Areskoug Josefsson, Kristina, 1973-, et al.
(författare)
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Education for sexual and reproductive health and rights (SRHR) : a mapping of SRHR-related content in higher education in health care, police, law and social work in Sweden
- 2019
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Ingår i: Sex Education. - : Taylor & Francis. - 1468-1811 .- 1472-0825. ; 19:6, s. 720-729
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Tidskriftsartikel (refereegranskat)abstract
- Knowledge of sexual and reproductive health and rights (SRHR) by health care, police, legal and social work professionals has been shown to be insufficient. This lack of competence is likely to affect the quality of services. The aim of this study was to describe SRHR indicators in educational programmes in health care, police, legal and social work higher education in Sweden. A text-based analysis was conducted of written material from all educational programmes in law, midwifery, nursing, occupational therapy, physiotherapy, police work, psychology, social work and undergraduate medicine (93 educational programmes at 27 universities and university colleges). Representation of different SRHR indicators varied, but most were poorly covered in the educational programmes. Existing educational programmes lack comprehensiveness in their coverage of SRHR and are unequal both within and between the professions and universities. This situation creates the risk of inequalities in SRHR competence and suggests that needs within this field may be unmet. There is an urgent need therefore to enhance the presence of SRHR in health care, social work and law enforcement education in Sweden.
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| 3. |
- Arvidsson, Anna, 1971-, et al.
(författare)
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School health-care team members’ reflections of their promotion of sexualand reproductive health and rights (SRHR) : Important but neglected
- 2024
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier. - 1877-5756 .- 1877-5764. ; 39
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Young people are prioritized regarding the promotion and safeguarding of sexual and reproductivehealth and rights – SRHR. In Sweden, the school is seen as an important arena with members of the school healthcare or SHC team as vital actors in this work. This study explored SRHR-related work in SHC teams in Sweden.Methods: Within an explorative qualitative design, structured interviews were conducted with 33 nurses, counsellors, SHC unit managers and headmasters. Reflexive thematic analysis was applied, and two main themesfound.Results: SHC team members see SRHR as an urgent topic, but address it only ‘when necessary’, not systematically– and they experience a shortage of guidance and cooperation regarding SRHR-related work. Even in a countrywith agreement on the importance of SRHR for all and on providing holistic comprehensive sex education inschools, young people are left to chance – i.e., to the SRHR competence in the professionals they meet.Conclusion: SHC team members in Sweden see SRHR as an urgent topic but do not address it systematically.Moreover, they experience a shortage of guidance for their work. To avoid any professional stress of conscienceand for equitable school health care regarding SRHR to be realized, research-informed policy needs to underlinesystematic, comparable and proactive practice.
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| 4. |
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| 5. |
- Björklund, Frida, et al.
(författare)
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“It’s easier to think outside the box when you are already outside the box” : A study of transgender and non-binary people’s sexual well-being
- 2024
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Ingår i: Sexualities. - : Sage Publications. - 1363-4607 .- 1461-7382. ; 27:3, s. 495-512
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Tidskriftsartikel (refereegranskat)abstract
- With a phenomenological approach, we explored transgender and non-binary people’s strategies to experience sexual well-being. Ten self-reports (seven interviews and three written texts) were analyzed, and the analysis resulted in six themes. The first three (Affirming oneself, Having access to care, and Being respected as one’s gender) were strategies for sexual well-being realized through affirming one’s identity, receiving the gender-confirming care wanted, and having one’s gender identity respected by others. The other three themes (Masturbating and fantasizing, Communicating and being open, and Being sexually free in queer spaces) were strategies for one aspect of sexual well-being—pleasure. The results describe strategies that all can learn from: the need to accept and appreciate oneself, not just adapt to gender norms of bodies and behaviors, and to communicate. In addition, it illuminates that being norm-breaking, or stepping out of the gendered paths presented to you, appears to provide new opportunities for people to learn what they enjoy, and this could lead to a broader repertoire of pleasurable sexual practices—practices that take bodily prerequisites into account
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| 6. |
- Carlström, Charlotta, lektor, et al.
(författare)
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LGBTQ plus Affirmative State Care for Young People in Sweden : New Knowledge and Old Traditions
- 2023
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Ingår i: British Journal of Social Work. - : Oxford University Press. - 0045-3102 .- 1468-263X. ; 53:8, s. 3744-3760
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Tidskriftsartikel (refereegranskat)abstract
- Young LGBTQ+ people are over-represented in various forms of state care. They experience hardships during their placements and staff competence in addressing specific needs among LGBTQ+ youth is lacking. In this article, we investigate whether and how LGTBQ+ issues are considered and described in digital marketing for state care providers. The material consists of the homepages of residential care homes and secure state care institutions, which we analyse using critical discourse analysis. The results show that LGBTQ+ issues are largely invisible. Of the approximately 1,000 existing state care providers, only twenty stated that they worked with or had competence in LGBTQ+ issues. Among these, no secure state care institution offered LGBTQ+ competence at the time of the study. The descriptions of how care providers work with LGBTQ+ issues are characterised by heteronormativity where there is a mix of two types of language on the homepages regarding LGBTQ+ youth; on the one hand, a heteronormative, traditional description based on a binary understanding of gender; and, on the other, an LGBTQ+ inclusive language is used. However, the LGBTQ+ affirmative language has been imposed upon the traditional rather than being integrated into it, which comes across as superficial and unclear. International studies show that LGBTQ+ youth are over-represented in various forms of state care. Using critical discourse analysis, we investigated how LGBTQ+ youth, as a target group, are described and how LGBTQ+ competence is presented on the home pages of residential care homes and secure state care institutions for young people in Sweden. The results show that LGBTQ is largely invisible. Of the approximately 1,000 existing residential care homes, only 20 stated that they worked with or had competence in LGBTQ+ issues. No secure state care institution offered LGBTQ+ competence at the time of the study.
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| 7. |
- Hammarström, Sofia, 1984-, et al.
(författare)
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Ask me, listen to me, treat me well and I shall tell: a qualitative study of Swedish youths’ experiences of systematic assessment of sexual health and risk-taking (SEXIT)
- 2022
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Ingår i: Sexual and Reproductive Health Matters. - : Informa UK Limited. - 2641-0397. ; 30:1
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Tidskriftsartikel (refereegranskat)abstract
- Sexual ill health among young people, in terms of sexually transmitted infections (STIs), unintended pregnancy, transactional sex and sexual violence, is a global public health concern. To that end, the SEXual health Identification Tool (SEXIT) was developed. The purpose of this study was to explore the visitors’ experiences of a youth clinic visit when SEXIT was used. A purposively selected sample of 20 participants (16–24 years of age) was recruited from three Swedish youth clinics using SEXIT. Participants were interviewed individually in March and April 2016, and data were analysed using inductive qualitative content analysis. The analysis resulted in four main categories describing the participants’ experiences of using SEXIT: “Issues of concern” includes descriptions of the items in SEXIT as important; “Enabling disclosure” describes how SEXIT serves as an invitation to talk and facilitates disclosure of negative experiences; “Road to change” captures experiences of the conversation with the healthcare professional; and “Managing power imbalance” describes experiences regarding the response and attitudes of the healthcare professional as well as the participants’ fears of being judged. The categories are connected by the overarching theme “Ask me, listen to me, treat me well and I shall tell”. This study contributes knowledge on young people’s experiences of a tool-supported dialogue on sexual health and risk-taking initiated by the healthcare professional. Structured questions in a written format, as a basis for dialogue, are appreciated and experienced as a functioning way of addressing sexual ill health and risk-taking at Swedish youth clinics.
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| 8. |
- Hammarström, Sofia, 1984-
(författare)
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Identification of young people at risk of sexual ill health : implementing a new tool in youth clinics
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Young people are at increased risk of sexual ill health in terms of sexually transmitted infections, unintended pregnancy, and sexual violence. There is limited knowledge of evidence-based preventive practices for identification of young people at risk of sexual ill health when in contact with health care. Aims: The overall aim of this thesis was to generate new knowledge concerning how Swedish youth clinics can work systematically to identify young people at risk of sexual ill health or who have negative sexual experiences. Specific objectives were to develop a risk-assessment model for the identification of youth at risk of contracting chlamydia; to develop and pilot-implement an evidence-informed tool for identifying young people at risk of sexual ill health in terms of sexually transmitted infections, unintended pregnancies, and sexual violence at Swedish youth clinics; and to explore youth clinic visitors’ and staff’s experiences of using that tool. Methods: The thesis takes a mixed methods approach and includes four studies. First, data from a national sample of sexually active young people, aged 15–24 years (n=6544), were used to develop a risk-assessment model for chlamydia infection. Second, a risk-assessment tool (SEXual health Identification Tool; SEXIT) was developed and pilot-implemented at three youth clinics for 1 month. The tool includes three components: (1) staff training; (2) a questionnaire for youth clinic visitors; and (3) a written guide for staff to support the subsequent dialogue and risk assessment based on the questionnaire. Questionnaire data from visitors (n=268) and staff (n=18) were analysed. Third, youth clinic visitors’ experiences were explored in 20 interviews with visitors (15–24 years) from the participating youth clinics. Fourth, staff’s experiences of working with SEXIT were investigated in four focus group discussions (n=16). Quantitative and qualitative methods were used for data analyses. Results: The risk-assessment model demonstrated that the distribution of chlamydia is skewed; 38% of cases were estimated to occur among a tenth of the population. Women most at risk of chlamydia were best identified using the variables age, number of sexual partners in the past year, and experience of sex for reimbursement. The corresponding variables for men were age, number of sexual partners, and alcohol use. SEXIT was validated and pilot-implemented at three youth clinics (response rate 86%). Before implementation, all staff perceived a need for more systematic screening for sexual risk-taking and sexual ill health at youth clinics. Youth clinic visitors demonstrated between 0 and 7 parallel risk factors. Staff experienced that using SEXIT systematically increased the consistency and quality of the clinics’ work, and youth clinic visitors reported that the questions were important and not uncomfortable or difficult. The visitors explained that questions in a written format followed by a dialogue initiated by the youth clinic staff enabled disclosure of negative experiences. Conclusions: The risk-assessment model demonstrates that the number of partners during the past year is the most important risk factor for chlamydia regardless of gender. SEXIT is an acceptable, appropriate, and feasible tool from the perspective of youth clinic staff, youth clinic visitors, and from an implementation point of view. Using the tool systematically may help raise important questions on sexual risk-taking and sexual ill health with youth clinic visitors and identify visitors with multiple risk factors. Being asked the sensitive yet important questions in SEXIT, followed by a respectful and non-judgemental conversation led by the youth clinic staff, has the potential to open up a more in depth and broader dialogue about the visitors’ sexual health. The systematic procedure helps youths feel that they are taken seriously and instils a feeling of trust that enables disclosure of sensitive experiences. From the staff perspective, SEXIT facilitates identification of young people exposed to or at risk of sexual ill health by simplifying and ensuring consistency and quality in their work.
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| 9. |
- Hammarström, Sofia, et al.
(författare)
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Identifying young people exposed to or at risk of sexual ill health: pilot implementation of an evidence-informed toolkit (SEXIT) at Swedish youth clinics
- 2019
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Ingår i: European Journal of Contraception and Reproductive Health Care. - : Informa UK Limited. - 1362-5187 .- 1473-0782. ; 24:1, s. 45-53
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: We aimed to develop and pilot-implement an evidence-informed toolkit (SEXual health Identification Tool; SEXIT) for identifying young people exposed to or at risk of sexual ill health, at Swedish youth clinics, and to investigate SEXIT’s potential to identify young people in need of special care and monitoring. Methods: The SEXIT toolkit was developed, validated and pilot-implemented at three Swedish youth clinics. Pre-implementation staff readiness was assessed and youth clinic visitors’ responses to SEXIT were analysed. Results: All staff perceived a need for screening for sexual risk-taking and exposure. The response rate from 268 youth clinic visitors (aged 15–24 years) was 86%. Half of the visitors had one or no variable associated with sexual ill health, a third had two or three, and 15% reported between four and seven variables. The most common variables were alcohol use, three or more sexual partners in the past year and previous chlamydia. Visitors rated SEXIT as important and not uncomfortable or difficult to answer. Conclusions: The SEXIT toolkit was found to be feasible and highly acceptable in a clinical setting. The use of SEXIT may facilitate important questions on sexual risk-taking and sexual ill health to be raised with youth clinic visitors. © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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| 10. |
- Hammarström, Sofia, et al.
(författare)
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Sexual health interventions for young people in state care: a systematic review
- 2018
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 46:8, s. 817-834
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To describe evaluated sexual health interventions for young people in state care and provide an assessment of the quality of and evidence for these interventions. Methods: A systematic review of sexual health interventions for young people in state care was conducted. Randomised controlled trials and quasi-experimental designs were eligible, 2051 records were screened, 412 full-text studies retrieved, and 12 publications with low-to-moderate risk of bias included. Results: Due to substantial heterogeneity in study populations, settings, intervention approaches, outcomes and measures, standard summary measures for intervention outcomes was not used. Instead, data were synthesised across studies and presented narratively. Conclusion: Without making recommendations, the result suggests that group-based educational interventions in general increase knowledge, attitudes and behaviour compared with standard care. However, these findings need to be further investigated, with a special emphasis on cultural context and the involvement of young people.
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| 11. |
- Hammarström, Sofia, 1984-, et al.
(författare)
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Staff´s experinces of the SEXual health Identification Tool (SEXIT)
- 2022
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Ingår i: ESC Abstract Book 2022. - : European Society of Contraception and Reproductive Health. ; , s. 88-89
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundIn 2016 SEXIT, an evidence-informed the toolkit, was developed and pilot-implemented at three Swedish youth clinics. Swedish youth clinics are highly accessible and focused primarily on concerns related to sexual and reproductive health and mental health among young persons aged 13-25 years. The SEXual health Identification Tool (SEXIT) was developed to facilitate identification of young people exposed to, or at risk of, sexual ill health in terms of sexually transmitted infections, unintended pregnancy, transactional sex, or sexual violence. The tool includes three components; (1) staff training, (2) a questionnaire for visitors, and (3) a written guide for staff to support the dialogue and risk assessment. Previous results demonstrated promising results; a high response rate from visitors (86%), few missing answers, and youth clinic visitors reporting factors associated with sexual ill health. Interviews demonstrated that youth clinic visitors appreciated structured questions in a written format as a basis for dialogue and found SEXIT appropriate for addressing sensitive topics. ObjectivesTo explore the youth clinic staff’s experiences of using SEXIT systematically with all visitors, with a focus on usefulness, implementation determinants, and feasibility of implementing SEXIT at Swedish youth clinics.MethodFour focus group discussions with youth clinic staff who participated in the pilot implementation. The clinics had used SEXIT systematically with all visitors for one month. Data were analysed using qualitative analysis designed for focus groups.ResultsMost participants experienced that the SEXIT routines were well functioning and that using SEXIT gave a comprehensive picture of the visitor and resulted in more concrete answers, which facilitated the risk assessment. Youth clinic staff experienced that SEXIT advanced their knowledge and the midwifes experienced that they identified more youth at risk with SEXIT, while the psychosocial staff were less convinced on how SEXIT best should be applied. Existing challenges related to the routines at the clinics and heavy workload during drop-in hours. Further, the staff were concerned about the continued care of vulnerable, and hard-to-reach youth clinic visitors that sometimes do not attend the scheduled revisits.Conclusions Staff experience SEXIT as useful for identifying young people exposed to or at risk of sexual ill health. Systematic use ensures consistency and quality in assessing the visitors, which may facilitate implementation. The use of SEXIT is challenged by heavy workload, conflicting routines, and the experience that some visitors identified through SEXIT decline further care. Implementation of SEXIT in Swedish youth clinics is considered feasible.
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| 12. |
- Hammarström, Sofia, 1984-, et al.
(författare)
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Staff's experiences of a pilot implementation of the SEXual health Identification Tool for assessing sexual ill health among visitors to Swedish youth clinics: A focus group study
- 2021
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Ingår i: Sexual and Reproductive Healthcare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 29
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Tidskriftsartikel (refereegranskat)abstract
- Background: Young people are disproportionally burdened by sexual ill health. The SEXual health Identification Tool (SEXIT) was developed for use at youth clinics, to facilitate identification of visitors exposed to or at risk of sexual ill health. The aim of this study was to explore experiences of using SEXIT among youth clinic staff who participated in a pilot implementation, with a focus on usefulness, implementation determinants, and feasibility of implementing SEXIT at Swedish youth clinics. Methods: Four focus group discussions were conducted with youth clinic staff from three clinics. The clinics had used SEXIT systematically in consultations with all visitors for one month. Data were analysed using qualitative analysis designed for focus groups. Results: Most participants experienced that the SEXIT routines were well functioning and that using SEXIT gave a comprehensive picture of the visitor and resulted in more concrete answers, which facilitated the risk assessment. The medical staff experienced that they identified more youth at risk with SEXIT, while the psychosocial staff were less convinced. Existing challenges related to the routines at the clinics and heavy workload during drop-in hours. Conclusions: Staff experience SEXIT as useful for identifying young people exposed to or at risk of sexual ill health. Systematic use ensures consistency and quality in assessing the visitors, which may facilitate implementation. The use of SEXIT is challenged by heavy workload, conflicting routines, and the experience that some visitors identified through SEXIT decline further care. Implementation of SEXIT in Swedish youth clinics is considered feasible. © 2021
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| 13. |
- Hammelev Jörgensen, Susanna, et al.
(författare)
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The Vicious Cycle of Magical Thinking : How IT Governance Counteracts Digital Transformation
- 2023
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Ingår i: Electronic Government. - : Springer. - 9783031411380 - 9783031411373 ; , s. 381-396
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Konferensbidrag (refereegranskat)abstract
- Digital transformation is associated with a fundamental change in the operating models of organizations and industries alike. At the same time, previous research highlights that existing governance practices may act as a deterrent to digital transformation. In this study, we explore how the IT governance of a large university counteracts necessary digital transformation in higher education over time. We show how the adoption of an industry-standard IT governance framework, through a series of generative mechanisms, leads to a vicious cycle that restricts digital transformation into mere computerization, thereby successfully counteracting digital transformation. In other words, the IT governance framework increasingly protects the organization from the organizational change brought on by new digital opportunities. This is discussed in relation to the literature on IT governance and digital transformation with the intent of contributing with a critical perspective on the widespread adoption and use of standard IT governance framework.
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| 14. |
- Hjalmarsson, Emma, et al.
(författare)
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"To live until you die could actually include being intimate and having sex" : a focus group study on nurses' experiences of their work with sexuality in palliative care
- 2020
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 29:15-16, s. 2979-2990
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of the study was to examine nurses' experiences of working with issues of sexuality in palliative care.BACKGROUND: Sexuality has value for human lives and relations and is important for one's overall well-being throughout life. Guidelines for palliative care state that sexuality should be addressed. Previous research shows that the inclusion of sexuality in general healthcare is deficient, and there is a knowledge gap on how sexuality is addressed in palliative care.METHOD: Within a qualitative design, the empirical material was obtained through three focus group interviews with eleven registered nurses working in palliative care. The interviews were analyzed using qualitative content analysis.RESULT: Nurses experience that sexuality has an indistinct place in their work, 'sexuality' is a word difficult to use, and differing views are held on whether it is relevant to address sexuality, and if so, when? Although they have experiences involving patient and partner sexuality, which is viewed as sexuality in transformation during the palliative care process, nurses seldom explicitly address patient or partner sexuality. Despite the lack of knowledge, routines and organizational support, they acknowledge the importance of addressing sexuality in palliative care, as they express that they want to do right.CONCLUSION: Overall, nurses appear to follow differing cultural, interpersonal and intrapsychic scripts on sexuality rather than knowledge-based guidelines. This underlines the importance of managers who safeguard the adherence to existing palliative care guidelines where sexuality is already included. In this work, it is important to be aware of norms to avoid excluding patients and partners that differ from the nurses themselves as well as from societal norms on sexuality.RELEVANCE TO CLINICAL PRACTICE: The results can be used as a point of departure when implementing existing or new guidelines to include and address sexuality and sexual health needs in palliative care.
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| 15. |
- Kristina, Areskoug-Josefsson, et al.
(författare)
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Exploring the role of sexual attitude reassessment and restructuring (SAR) in current sexology education : for whom, how and why?
- 2022
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Ingår i: Sex Education. - : Taylor & Francis. - 1468-1811 .- 1472-0825. ; 22:6, s. 723-740
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Tidskriftsartikel (refereegranskat)abstract
- As concerns about sexual and reproductive health and rights become integrated into public health policies, the demand for higher education in sexology rises. There is a need therefore to evaluate established pedagogical methods to ensure that they are relevant, efficient and lead to valuable competencies. This study explored the current evidence and pedagogical relevance for Sexual Attitude Reassessment and restructuring (SAR) as part of professional higher education in sexology. A systematic review was conducted with eleven included publications. Data were synthesised across studies and presented narratively. The publications were generally old and derive from a small pool of researchers geographically centred to the USA. Several studies were based on small numbers of participants, display a great variety in types of participants, use different evaluation instruments (mostly unvalidated), and a variety of methods to measure the results of SAR. Furthermore, long-term follow-up has been rare. Extensive, high-quality, and up-to-date research for SAR as an effective pedagogical method for use in sexology higher education for professionals today is lacking. Digital solutions focusing on broadening students sexological self-awareness appear more feasible than SAR, and suitable pedagogical and digital solutions need to be developed and evaluated to ensure high-quality teaching of sexology in higher education.
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| 16. |
- Larsdotter, Suzann, et al.
(författare)
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Educator and staff perspectives on a rights-based sex education for young men in jail and prison in Sweden
- 2022
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Ingår i: Sex Education. - : Taylor & Francis. - 1468-1811 .- 1472-0825. ; 23:1, s. 114-127
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Tidskriftsartikel (refereegranskat)abstract
- Young men in jail and prison are vulnerable regarding sexual health and the fulfilment of their sexual rights. As a response to this, the Swedish Association for Sexuality Education (RFSU) has been providing sex education to young, incarcerated men, via a project initiated by and in cooperation with the Swedish Prison and Probation Services (SPPS). This article is a qualitative exploration of how RFSU educators experienced their work, and of how staff within SPPS experienced the initiative. Eight RFSU educators, and six persons working within SPPS were interviewed, and a thematic analysis was conducted. Overall, the experiences described by RFSU educators and by SPPS staff were similar, they regarded sex education sensitive to what young men wanted to discuss as valuable and the project feasible. Future improvement areas include strategies on how to handle toxic masculinity among young men in jail and prison. Additionally his, the different aims that the organisations RFSU and SPPS have, and how young men navigate them, must be acknowledged. Young men’s voices are missing in this study, and examining their experiences of the sex education in future work would be valuable.
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| 17. |
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| 18. |
- Lindroth, Malin
(författare)
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'Competent persons who can treat you with competence, as simple as that' : an interview study with transgender people on their experiences of meeting health care professionals
- 2016
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 25:23-24, s. 3511-3521
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. With a focus on sexual health and rights, this study describes how transgender people experience meetings with health care professionals. Background. Transgender people face prejudice and discrimination worldwide. Little is known of their experiences in sexual health-promoting settings. Method. Within a descriptive design, 20 persons aged 18-74 and identifying as transgender and nonbinary were interviewed. The results were analysed with constructivist grounded theory. Results. Disrespect among health care professionals is the core category connected to the experiences in the result; transgender people experience estrangement, expectations and eviction in different sexual health-promoting settings. Conclusion. Transgender knowledge needs to be increased in general, in both specialised transgender health care and many other health care settings, to prevent transgender peoples' experiences of estrangement. Moreover, an increased knowledge of, and respect for, sexual health and rights is needed to prevent transgender peoples' exposure to gender binary, cis- and heteronormative expectations. In addition, access to sexual health care is essential following gender-confirmatory care as well to avoid transgender peoples' experiences of eviction from the health care system. Relevance to clinical practice. Nurses have an important role to play in striving for equity and justice within health care. This study describes how health care professionals appear to be disrespectful and suggestions of how this can be avoided are made.
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| 19. |
- Lindroth, Malin, et al.
(författare)
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Marginaliserad sexualitet? Tvångsomhändertagna ungdomars attityder, erfarenheter och handlingar
- 2012
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Ingår i: Socionomens forskningssupplement. - : SSR. - 0283-1929. ; :31, s. 44-52
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Tidskriftsartikel (refereegranskat)abstract
- Tvångsomhändertagna ungdomar är riskutsatta på många områden. Denna artikel fokuserar specifikt ungdomar på statliga ungdomshem. Vi redogör för hur ett urval av dessa unga har svarat i en enkätundersökning rörande sexuell hälsa samt hur deras svar på flera väsentliga punkter skiljer sig från övriga unga. Forskningsresultatet som är det första i sitt slag i Sverige stämmer väl överens med tidigare forskning som visar på samband mellan flera olika riskfaktorer eller riskbeteenden varav sexuellt risktagande är ett. Tillika ger det viktig kunskap att använda vid utformandet av en målgruppsanpassad modell för sex- och samlevnadsundervisning.
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| 20. |
- Lindroth, Malin, et al.
(författare)
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Marginalized sexuality? Attitudes and experiences among adolescents in compulsory care
- 2011
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Every year approximately 1500 adolescents (aged 12-20) are placed at Swedish detention homes run by the National Board of Institutional Care (SiS) according to the laws of “The young persons act” or “Secure institutional treatment for young offenders instead of prison”. Little is known about the sexual health of these adolescents, although earlier research, mainly international, strongly indicates that troubled youths in general are subjected to sexual exposure. Methods: A survey covering different aspects of sexual health with 148 boys (64 %) and girls (36 %) with an average age of 17 at Swedish detention homes was conducted. The survey focused sexual knowledge, attitudes and behaviours and the results were compared with the answers from other youths. Results: The adolescents at detention homes holds different attitudes towards sexuality compared to the ones in the national sample. They are to a greater extent, the boys more than the girls, negative towards homosexual relations; the girls’ sexual actions are judged harder than boys’; and none considered themselves as being homosexual although close to one third of the girls consider themselves as being bisexual. The average age for sexual debut, which most commonly took place with an older person with whom the boy or girl did not have an ongoing relationship, is three years earlier compared to other youths. Alcohol and drugs during sexual debut, experiences of sex against ones will, of selling and buying sex, of unprotected vaginal intercourse, of becoming or making someone pregnant is more common within the group. Conclusion: The results, although not unexpected, provides important knowledge to be used in comprehensive sexual health education which we suggest should be offered these young persons during their stay at the youth detention homes. The aim is to develop such a curriculum, let the detained adolescents reflect upon it in focus-groups and implement it.
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| 21. |
- Lindroth, Malin
(författare)
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On the Outskirts of the Charmed Circle : Challenges and Limitations of Sexual Health Promotion to Young People in Secure State Care
- 2021
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Ingår i: Sexuality Research & Social Policy. - : Springer. - 1868-9884 .- 1553-6610. ; 18, s. 87-96
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Young people on the verge of, or in, secure state care or incarceration have reduced general and sexual health. The promoting of sexual health among young people in secure state care is therefore a responsibility for both the state-run agency responsible for this care and for the professionals who work there. Methods This position paper discusses sexual and reproductive health and rights (SRHR) for young people in secure state care in Sweden. Four previous studies on sexual health of young people in secure state care are revisited, and governmental policy documents are examined. Results Young people in secure state care face many threats to their sexual and reproductive health and rights. Some of these threats originate with the institutional placement itself and the lack of knowledge among the staff. Clashes on various levels between the subjectively desired (young people seeking pleasure from sex, alcohol, or other drugs) and the societally desired (sexual health, minimal alcohol use, and no drug use among young people) are described. In addition, clashes are seen between young people who want to be like everyone else in their social context and the staff with a mission (i.e. job description) to readjust young people into adopting socially accepted behaviour. Conclusion I argue that young people in secure state care have sexual experiences that are marginalized and placed on the outskirts of the charmed (sexual) circle of societally accepted sexual behaviour. In addition, their experiences are surrounded by silence, a silence sustained by both young people and professionals. The readiness of professionals to handle SRHR for young people in secure state care in a knowledge-based and non-judgemental fashion is crucial. Future research should focus on this readiness and have the needs and wishes of young people as its departing point. Although the article involves a local context, it may be of interest to a wider audience, as the placement of young people in secure state care and other forms of incarceration occurs worldwide.
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| 22. |
- Lindroth, Malin, 1968-, et al.
(författare)
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Rätten till hälsa : Hur normer och strukturer inverkar på transpersoners upplevelser av sexuell hälsa
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Denna rapport handlar om transpersoners upplevelser och beskrivningar av sexuell hälsa och baseras på en kvalitativ intervjustudie. Utgångspunkten för studien är Folkhälsomyndighetens arbete med nationella strategin mot hiv och aids och vissa andra smittsamma sjukdomar (proposition 2005/06:60) samt uppföljningen av hälsan bland trans-personer inom regeringens strategi för lika möjligheter och rättigheter oavsett sexuell läggning, könsidentitet eller könsuttryck.Resultatet innehåller transpersoners egna beskrivningar och utsagor kring möjligheter och hinder till sexuell hälsa samt berör sexuellt risktagande och erfarenheter av möten med personal inom hälso- och sjukvården. Resultaten visar att respekt är centralt för upplevelsen av sexuell hälsa– respekt för sig själv, sin kropp och sina känslor samt respekt från andra i intima relationer och relationer med personal inom hälso- och sjukvården.Rapporten riktar sig till främst till personal inom hälso- och sjukvården, kommuner landsting, relevanta myndigheter och ideella organisationer inom området. Förhoppningen är att rapporten kan bidra med insikt och kunskap om transpersoners livssituation i relation till sexualitet, sexuell hälsa och sexuellt risktagande samt ge underlag avseende hälsofrämjande och sjukdomsförebyggande arbete.
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| 23. |
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| 24. |
- Lindroth, Malin
(författare)
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Sex education and young people in group homes : balancing risks, rights and resilience in sexual health promotion
- 2014
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Ingår i: Sex Education. - : Routledge. - 1468-1811 .- 1472-0825. ; 14:4, s. 400-413
-
Tidskriftsartikel (refereegranskat)abstract
- This paper presents findings from focus group interviews conducted in Swedish government group homes for young people with a history of psychosocial problems, substance misuse and criminal behaviour. Participants were asked to reflect on a newly developed sex education curriculum located within a harm-reduction paradigm prior to its implementation. In addition to appreciating the proposed 10 sessions, young people positively evaluated the proposed dialogical and norm critical teaching style as likely to facilitate productive discussion about sexuality. Findings will contribute to future implementation of the sex education curriculum across a range of institutional settings. Results also highlight the democratic aspects of involving vulnerable young people in matters that directly concern them, and underline the importance of properly contextualised forms of sex education.
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| 25. |
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| 26. |
- Lindroth, Malin, et al.
(författare)
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Sexual chance taking : A qualitative study on sexuality among detained youths
- 2013
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Ingår i: European journal of contraception & reproductive health care. - : Informa Healthcare. - 1362-5187 .- 1473-0782. ; 18:5, s. 335-342
-
Tidskriftsartikel (refereegranskat)abstract
- Many, although not all, juvenile detainees are known to be sexual risk-takers but little attention has been paid to why they engage in early sexual intercourse, have more partners, often have sex under the influence of drugs or alcohol, and without protection. To understand the rationale behind sexual risk-taking among detained adolescents. Qualitative study of interviews with nine girls and 11 boys, aged 15 to 20 years, at detention centres in southern Sweden. Two major categories surface in the analysis of the interviews: contradictions and vulnerability. A core category, chance outdoes risk that describes the adolescents' pragmatic view on sexual risk-taking as being a chance of something good rather than a risk of something bad, captures the connection between these categories and the individual. Among our interviewees, sexual chance taking appears rewarding. Recognising this rationality is valuable for all professionals promoting sexual health within similar groups of youths.
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| 27. |
- Lindroth, Malin, et al.
(författare)
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Sexual health among transgender people in Sweden
- 2017
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Ingår i: International Journal of Transgenderism. - : Taylor & Francis. - 1553-2739 .- 1434-4599. ; 18:3, s. 318-327
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Transgender people´s general health and sexual function has previously been studied. However, holistic sexual health—physical, emotional, and relational well-being in relation to sexuality—as both a determinant for and a part of general health is an understudied field in research concerning health among transgender people. There is no research addressing holistic sexual health and sexual health determinants combining quantitative and qualitative data.Aim: To explore and describe holistic sexual health and sexual health determinants among transgender people in Sweden.Methods: For the purpose of this paper, descriptive statistics from a previous web-based survey with 796 respondents and quotes from a previous qualitative interview study with 20 transgender people were combined.Results: Physical, emotional, and relational well-being are all vital aspects for experiencing holistic sexual health; that is, they are all important sexual health determinants, although of different importance to different individuals at different times. Satisfaction with sex life, having an ongoing sexual relationship and having been exposed to disrespectful or discriminatory care are examples of physical, emotional, and relational sexual health determinants that are connected to factors such as condom use, access to respectful STI/HIV-testing and having received reimbursement for sex. Experiences of disrespect and discrimination were reported in both the qualitative and the quantitative data, and in the qualitative data a wish for equity in access to sexual health care is evident.Conclusion: The results provide a broad and extensive insight into transgender people´s sexual health in Sweden. Furthermore it underlines that access to nondiscriminatory health care services is vital, including access to gender-confirming care and different sexual-health-promoting and preventive services such as testing facilities.
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| 28. |
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| 29. |
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| 30. |
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| 31. |
- Lindroth, Malin, et al.
(författare)
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SGBA and the social determinants of health : Public health, human rights and incarcerated youth
- 2021. - 1
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Ingår i: Sex and gender-based analysis in public health. - Switzerland : Springer. - 9783030719289 - 9783030719296 ; , s. 139-148
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- In this chapter, we focus on a sex- and gender-based analysis (SGBA) concerning young people incarcerated in state institutions in Sweden. We identify and discuss specific areas concerning sexual and reproductive health and rights (SRHR) wherein normative assumptions affect incarcerated young people’s sexual health and their access to sexual health services.Governments and related public health agencies must ensure, on both policy and practice levels, that inequalities in access to sexual health care and related sexual health outcomes for incarcerated young people are addressed. In Sweden, policies exist, including the use of a sex- and gender-based analysis, but clear action on the practice level is lacking. The national Public Health Agency has addressed young people in secure state care as a group in need of interventions, but in light of the analysis made, we see several challenges that need to be addressed: (1) the lack of SRHR competence in staff, (2) the organization of sexual and reproductive health care being unclear and risking the accessibility for incarcerated youth, and (3) the organization of secure state care builds on gender-stereotypical, heteronormative, and cis-normative ideas of youth sexualities and identities, which risks emphasizing existing vulnerabilities. This is evident both in the case of gender-separated wards and in the implicit ideas of youth sexualities and identities that organize the care. In conclusion, public health at all levels has a key role to play in working concretely to address the sex- and gender-based challenges to sexual health outcomes of youth in secure care.
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| 32. |
- Lindroth, Malin, 1968-, et al.
(författare)
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Social Workers as Allies? Gender Confirming Practices and Institutional Limitations in Youth Residential Homes
- 2024
-
Ingår i: Clinical social work journal. - : Springer Science+Business Media B.V.. - 0091-1674 .- 1573-3343.
-
Tidskriftsartikel (refereegranskat)abstract
- Previous research shows that LGBTQ+ youth are over-represented in out-of-home care and that especially transgender andnon-binary youth face challenges during their placement. These challenges stem from, among other factors, the lack ofknowledge and competence of professionals regarding the unique needs of transgender and non-binary youth. In Sweden,there are policies that aim to protect transgender and non-binary youth from discrimination and to promote their sexualand reproductive health and rights, and an increasing number of residential homes claim to have LGBTQ competencewhen competing for placements. However, it is unclear how this affects the everyday experiences of trans and non-binaryyouth at residential homes. The purpose of this study is to investigate the practices and challenges of clinical social workers at residential care homes when working with gender identity and sexual health issues among young transgender andnon-binary youth. Eight semi-structured interviews focusing on professionals’ knowledge and experiences were conductedand analysed using reflexive thematic analysis. Four themes emerged: i) Knowledge being a personal matter; ii) Heteronormativity and binarity creating consequences; iii) Handling discrimination and harassments; and iv) Creating a trustfulalliance. The results show that knowledge is a personal matter, and social work professionals seek the knowledge theyneed instead of receiving it in education or training. The contextual heteronormativity and binarity creating consequencesat the residential care home pose challenges for social workers and they have to find creative ways to support transgenderand non-binary youth and address the harassments and discrimination that these youth face. Moreover, the social workersshare their strategies regarding how they are creating a trustful alliance. Overall, they identify significant challenges todeveloping clinical social work that is affirming of transgender and non-binary youth.
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| 33. |
- Lindroth, Malin, 1968-
(författare)
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Socialt utsatta unga och sexuell hälsa
- 2015
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Ingår i: Jordemodern. - : Svenska Barnmorskeförbundet. - 0021-7468. ; :12, s. 14-15
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Tidskriftsartikel (populärvet., debatt m.m.)
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| 34. |
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| 35. |
- Lindroth, Malin, 1968-
(författare)
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Transpersoner och sexuell hälsa
- 2015
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Ingår i: Jordemodern. - : Svenska Barnmorskeförbundet. - 0021-7468. ; :12, s. 23-24
-
Tidskriftsartikel (populärvet., debatt m.m.)
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| 36. |
- Lindroth, Malin, et al.
(författare)
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Unequal sexual health : differences between detained youth and their same aged peers
- 2013
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 41:7, s. 722-728
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: To describe sexual health risks in an understudied group, youth in detention, and compare these to sexual health risks among non-detained youth. In addition, variables predicting adverse sexual health outcomes are sought and compared. Methods: In 2009, a self-administered questionnaire on sexuality was conducted amongst youth in Sweden. In 2010, the same Internet-based questionnaire was applied in a study at Swedish detention centres. In this article, sexually active youth aged 15–20 years in the two groups are compared and bivariate logistic regression analyses are conducted in order to find predictors of adverse sexual health outcomes, among detainees and non-detainees respectively. Results: Major differences between the detained and the non-detained concerning a majority of risk-taking variables exist. Conclusions: Although detained youth display several risky sexual behaviors, no specific risk factors are found in a logistic regression analysis. However, this is a vulnerable group. The mere fact that an adolescent is placed at a detention centre should be an imperative for professionals to address the subject of sexual health and safer sex. Furthermore, the results will be used in a forthcoming sex education curriculum tailored especially at detained youth. This is one, but by far not the only way to minimize the health inequalities that are presented in this study.
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| 37. |
- Lindroth, Malin
(författare)
-
Utsatthet och sexuell hälsa : en studie om unga på statliga ungdomshem
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The dissertation concems youths in detention at residential group homes, their sexuality in general, their sexual health in particular. and their sex education. According to Swedish law, sex education is required in the Swedish public school system.The education must be perceived as relevant by youths and promotion rather than preventive-focused. Despite this legislative measure, Swedish research data on this youth population are scarce; available international research shows that youths in detention have poor sexual heal th. The aim is thus to gain knowledge about the sexual health among youths in detention at residential group homes, and to develop and present a sex education curriculum targeted to their special needs. A survey followed by an interview study seeks to assess knowledge of sexual health among these adolescents (papers I-III). Exposure to untoward sexual behaviors alongside sexual risk taking is found, concomitant to apportunities for these youths to experience healthy sexual encounters that may outweigh the risks. Furthermore, this group of detained adolescents are more risk taking and exposed to negative sexual experiences compared to their non-detained same aged peers. In focus group interviews, the sex education curriculum is presented to the detainees (paper IV). They consider the information relevant and share advice of how to furtherad just the material to thei r needs. The data are discussed from the perspective of social psychology, and the rationale behind the youths' risk taking is explored. The study pennits the voices of the youths be heard; it presents a nuanced portrait of the camplexity behind their sexual risk taking and elucidates the pereceived advantages of unsafe sex. The results are of i nterest to researchers and clinicians in areas of sociaJ work where specialized knowledge of socially disadvantaged youth and sexual health has been lacking.
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| 38. |
- Lindroth, Malin, et al.
(författare)
-
WHEN OPPORTUNITY OUTDOES RISK : SEXUAL RISK-TAKING AMONG ADOLESCENTS AT YOUTH DETENTION CENTERS
- 2011
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Youth subjected to enforced placement due to criminality, alcohol or drug abuse or antisocial behavior is a vulnerable group; their overall health as well as their sexual health is lower than the one of their non-detained peers. In a previous survey 2010 we found elevated sexual risk-taking among Swedish adolescent at detention centers. What is the underlying significance of these risky sexual actions, such as first intercourse at the age of 11-12, sex under the influence of drugs or alcohol, and/or having unprotected sex with an unknown partner? Methods: In-depth interviews were conducted in 2011 with 9 girls and 11 boys aged 15-20 who at the time of the interviews were subject to mandatory care in enforced placement. Using constructivist Grounded Theory, these interviews were analyzed jointly with the results from a previous 2010 survey that included 148 detainees aged 15-20. Results: The sexual risk-taking can be understood along three separate but intersecting dimensions: the individual, the group and the society. Individual differences such as gender, age, ethnicity, substance abuse and cognitive ability affect the risk-taking. Furthermore, low school attendance leads up to a lack of basic sexual knowledge, and alcohol and drug use, and a chaotic lifestyle all contribute to hazardous risk assessment. On a group level the interned youth are seeking intimacy, confirmation and a sexual identity as other youth However, their search is on a societal level an ambivalent one, as they navigate between traditional and modern sexual norms. In their ongoing marginalized life, the desire to experience something good (intimacy, confirmation, pleasure), outweighs the risk for something bad (STI, unwanted pregnancy, unwanted sex) which lead to a pragmatic view of sex and sexual risk-taking. Conclusion: Respect for this pragmatic sexual risk-taking and its many different layers of origin as well as for its positive meaning for the adolescents is needed. Furthermore, understanding these intersecting dimensions is essential if preventive work within this group is to be regarded as relevant by the adolescents themselves. Key-words: sexual health, risk-taking, youth, youth detention centers, prevention, safer sex
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| 39. |
- Lindroth, Malin, et al.
(författare)
-
When opportunity outdoes risk : sexual risk-taking among adolescents at youth detention centers
- 2012
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Youth subjected to enforced placement due to criminality, alcohol or drug abuse or antisocial behavior is a vulnerable group; their overall health as well as their sexual health is worse than the one of their non-detained peers. In a previous survey we found elevated sexual risk-taking among Swedish adolescent at detention centers. What is the underlying significance of these risky sexual actions, such as first intercourse at the age of 11-12, sex under the influence of drugs or alcohol, and/or having unprotected sex with an unknown partner? Methods: In-depth interviews were conducted in 2011 with 9 girls and 11 boys aged 15-20 who at the time of the interviews were subject to mandatory care in enforced placement. Using constructivist Grounded Theory, these interviews were analyzed jointly with the results from a previous 2010 survey that included 148 detainees aged 15-20. Results: The sexual risk-taking can be understood along three separate but intersecting dimensions: the individual, the group and the society. Individual differences such as gender, age, ethnicity, substance abuse and cognitive ability affect the risk-taking. Like most adolescents in a normative context, the interned youth are seeking intimacy, confirmation and a sexual identity. Their search is an ambivalent one, as they navigate between traditional and modern sexual norms. For these teens from difficult backgrounds and with deleterious experiences, this process begins at an early age. Low school attendance leads up to a lack of basic sexual knowledge; in addition, alcohol and drug use, and in many instances a chaotic lifestyle all contribute to hazardous risk assessment. In their ongoing marginalized life, the desire to experience something good (intimacy, confirmation, pleasure), outweighs the risk for something bad (STI, unwanted pregnancy, unwanted sex). A pragmatic view of sex and sexual risk-taking occurs among the youth in this impacted population. Conclusion: Respect for this pragmatic sexual risk-taking and its many different layers of origin as well as for its positive meaning for the adolescents is needed. Furthermore, understanding these intersecting dimensions is essential if preventive work within this group is to be regarded as relevant by the adolescents themselves.
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| 40. |
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| 41. |
- Löfgren-Mårtenson, Lotta, et al.
(författare)
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”Det är värt risken” Unga inom Sis och sexuell hälsa
- 2013
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Rapporten presenterar en intervjustudie om sexuell hälsa bland unga, som har genomförts på två av SiS särskilda ungdomshem. Studien baseras på 20 intervjuer med nio flickor och elva pojkar i åldrarna 15–20 år. Ett särskilt fokus läggs på ungdomarnas egna erfarenheter, attityder och kunskaper. Ungdomarna beskriver sexualiteten främst som en möjlighet att få något positivt, såsom närhet, njutning och bekräftelse, medan risken att drabbas av sexuellt överförbara sjukdomar, sexuella övergrepp eller oönskade graviditeter tonas ner. Ungdomarna tycks navigera i det sexuella landskapet med hjälp av olika strategier: bagatellisering av sexuella risker, bedömningar av sexuella risksituationer baserat på partnerns utseende och rykte, känslomässigt distanserande, senareläggande av tidpunkten för den sexuella debuten då denna varit ett övergrepp samt kompensatoriska handlingar. Kanske är det just trygghetslängtan och bilden av kompensatoriska strategier i avsikt att söka sig till närhet och intimitet, som är den viktigaste pusselbiten i förståelsen av de ungas utsagor om sexuellt agerande. ISBN 978-91-87053-20-7 ”Det är värt risken” Unga inom SiS och sexuell hälsa Lotta
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| 42. |
- Magnusson, Emilie, et al.
(författare)
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'We try' - how nurses work with patient participation in forensic psychiatric care
- 2020
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 34:3, s. 690-697
-
Tidskriftsartikel (refereegranskat)abstract
- RationalePatients in secure forensic psychiatric care have reduced autonomy because of the constraints imposed on them by compulsion laws. Thus, it is vital that nurses enable patient participation whenever possible. Patient participation, and it′s clinical use in forensic psychiatric care, is an understudied field.AimTo describe nurses’ experiences of their work with patient participation in forensic psychiatric care.MethodsManagers at different secure forensic psychiatric institutions in the south of Sweden approved the study, and oral consent was retrieved from informants. Interviews guided by a semi‐structured interview guide were conducted with nine nurses from five different forensic psychiatric institutions and analysed with content analysis.FindingsNurses describe diverse understandings and abilities in an inflexible setting. This indicates that what participation is, and how to achieve it, is not the same for nurses as for patients. Moreover, patients have different abilities to participate, and the secure setting in itself is perceived as hindering participatory work. Still, participation is described as a crucial part of work that requires a caring relationship. Furthermore, nurses pronounce potentially excluding attitudes and strategies that may obstruct patient participation for all, and at the same time, they have a belief that improvement is possible.ConclusionCompulsory forensic psychiatric care is a complex care context that requires constant efforts from nurses to balance patients’ rights and needs with mandatory care. The very nature of this caring context appears to be a major obstacle when promoting patient participation. Nevertheless, nurses express that they do aim for patient participation, ‘they try’. From a patient's perspective, trying is not sufficient and a need for improvement is evident. The results can be of clinical interest in similar secure forensic psychiatric nursing settings, and a point of departure in future development of care striving for increased patient participation for all.
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| 43. |
- Schindele, Anna ChuChu, et al.
(författare)
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Analysing intersecting social resources in young people’s ability to suggest safer sex - results from a national population-based survey in Sweden
- 2022
-
Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 22:1
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundSafer sex is one of the most crucial areas in sexual and reproductive health and rights (SRHR). Drawingon the theory of health promotion where social life generates resources for health our hypothesis is that having controlover one’s life situation, affects the ability for safer sex and thereby sexual health. The aim is to explore the associationbetween having control over one’s life and the ability to suggest safer sex among young people aged 16–29, andhow this plays out in relation to membership of six constructed social groups based on: gender, transgender experience,sexual identity, economy, being foreign-born, and social welfare recipiency followed by an in-depth analysis ofthe intersection of gender and sexual identity.MethodsThe data set comprises cross-sectional survey responses from a stratified random sample of 7755 in thetotal Swedish population of young people. The SRHR-focused questionnaire was developed within the HIV-monitoringprogram at the Public Health Agency of Sweden. Data collection was conducted by Statistics Sweden betweenApril 15 and June 8 in 2015. The survey had a response rate of 26%, which was in line with the study design. Statisticalanalysis was used to explore the self-reported outcome variable ability for safer sex and the exposure variable controlover one’s life. The methods used comprise multivariate logistic regression and an intersecting multivariate regressionexploring 12 intersecting social positions by gender and sexual identity.ResultsThe results show that young people’s control over their lives is associated with their ability for safer sex. Dueto this, control over one’s life can be seen as a resource for safer sex. The associations in the 12 intersecting social positionsshowed complex patterns.Conclusions: The intersections of resources show the complexity and that gender cannot account for all differencesin the resources for young people’s ability to suggest safer sex. Implications for policy and practitioners involve bothaddressing and strengthening the sexual rights of young people from sexual minorities and tailoring interventions ina way that takes the intersections between gender and sexual identity into consideration.
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| 44. |
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| 45. |
- Schindele, Anna ChuChu, et al.
(författare)
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Kartläggning av utbildning i hivprevention och SRHR : En kartläggande studie om hivprevention samt sexuell och reproduktiv hälsa och rättigheter (SRHR) inom människo- och rättsvårdande högre utbildning i Sverige
- 2017
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- BakgrundDen här rapporten är en del av Folkhälsomyndighetens uppföljning av arbetet med hivprevention samt sexuell och reproduktiv hälsa och rättigheter (SRHR) bland unga och unga vuxna. Arbetet utgår från regeringens proposition Nationell strategi mot hiv och aids och vissa andra smittsamma sjukdomar och genomfördes inom ramen för Nationell handlingsplan för klamydiaprevention 2009–2014.MetodKartläggningen är en textbaserad granskning av högre utbildning till arbetsterapeut, barnmorska, fysioterapeut, jurist, läkare, polis, psykolog, sjuksköterska och socionom. En gemensam nämnare för de olika utbildningar som ingår är att de alla förbereder den studerande för ett självständigt arbete av människo- eller rättsvårdande karaktär där den professionella möter människor i olika livssituationer. Granskningen omfattade yrkesbeskrivningar, utbildningsplaner och kursplaner på 93 utbildningsprogram vid 27 högskolor och universitet i Sverige. Vid granskningen gjordes en kategorisering av utbildningarnas innehåll utifrån indikatorer som relaterar till SRHR-området. Indikatorerna togs fram med stöd av en referensgrupp.Resultat och slutsatsResultatet visar att hivprevention och SRHR sällan förekommer i yrkesbeskrivningar, utbildningsplaner och kursplaner på de utbildningar som undersökts. Detta kan leda till att studenter inte får med sig relevanta kunskaper. Det finns särskilt lite indikatorer för SRHR inom universitets och högskolors professionsutbildningar till: sjuksköterska, socionom, jurist, polis, psykolog samt arbetsterapeut och fysioterapeut. Barnmorska och läkare har fler indikatorer inom SRHR än övriga utbildningar som studerats men trots det är områden som: sex mot sin vilja, hedersrelaterat våld, sex mot ersättning och heteronormen inte alls förekommande samt att området sexuellt våld är mycket lite belyst.I förlängningen kan detta leda till kompetensbrist kring sexualitetsområdet och dess betydelse för hälsan. Det kan också försvåra förståelsen för klienters och patienters behov och rättigheter. Högskolor och universitet bör se resultaten som underlag för fortsatt utvecklingsarbete av yrkesutbildningarna. Studenter behöver få möjlighet att i sin kommande yrkesroll stödja alla människors rätt att uppnå sexuell och reproduktiv hälsa och rättigheter oavsett kön, ålder, sexuell läggning, könsidentitet, funktionalitet, socioekonomisk position, etnicitet, kulturell bakgrund och juridisk status.
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| 46. |
- Schindele, Anna ChuChu, et al.
(författare)
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Perceived knowledge gained from school-based sexuality education : results from a national population-based survey among young people in Sweden
- 2023
-
Ingår i: Sexual Health. - : CSIRO Publishing. - 1448-5028 .- 1449-8987. ; 20:6, s. 566-576
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundSchool-based sexuality education is a core component of securing young people’s right to attain health equity regarding sexual and reproductive health and rights. This paper aims to explore how perceived knowledge (sufficient or insufficient) of taking care of one’s sexual health is associated with knowledge gained from school-based sexuality education and social determinants.MethodsThe data material is drawn from a population-based survey conducted in Sweden in 2015. The survey had 7755 respondents and a response rate of 26%. To explore the aim descriptive statistics and logistic regression models were used.ResultsOur results show that perceived insufficient knowledge from school-based sexuality education was associated with higher odds of reporting not being able to take care of one’s sexual health. The highest significant excess risk for insufficient knowledge was found among young people from sexual minorities.ConclusionsYoung people in Sweden do not have equal abilities to receive knowledge needed to take care of their sexual health and thus attain sexual health literacy. There is an unequal distribution of perceived knowledge, and LGBTQI+ youth particularly face barriers in using school-based sexuality education as a resource for sexual health literacy.
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| 47. |
- Schindele, Anna ChuChu, et al.
(författare)
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Sexual and reproductive health and rights (SRHR) among young people in secure state care and their non-incarcerated peers : a qualitative, descriptive and comparative study
- 2021
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Ingår i: European Journal of Social Work. - : Routledge. - 1369-1457 .- 1468-2664. ; 24:4, s. 657-670
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Tidskriftsartikel (refereegranskat)abstract
- Young people in secure state care have impaired general as well as sexual health. Social work practice that addresses SRHR among young people in secure state care is thus called for. Using a qualitative design, this descriptive and comparative paper combines the results of two separate surveys on sexual health with young people 16-29 years old. 7755 young women and men in Sweden and 117 young women and men in secure state care in Sweden participated. The results show large differences in sexual health between the groups. Young women in secure state care are the most vulnerable. Implications for social work are discussed, and a SRHR-affirmative perspective is suggested. This SRHR-affirmative practice is particularly important when social work involving young people is organised in a compulsory fashion.
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| 48. |
- Schindele, Anna ChuChu
(författare)
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Vulnerabilities and Resources : Exploring intersecting conditions for health equity in sexual and reproductive health and rights(SRHR) among young people in Sweden
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- SVENSK SAMMANFATTNINGBAKGRUND: Sexuell och reproduktiv hälsa och rättigheter (SRHR) är en central bestämningsfaktor för hälsa och utgör en viktig del av livet i övergången från barndom till vuxen ålder. Den nationella SRHR-policyn i Sverige strävar mot jämlika förutsättningar för hälsa. I Sverige idag är sexuellt överförbara infektioner (STI) vanliga, vilket tyder på att det behöver ske en beteendeförändring där fler unga har säkrare sex. Resultat från tidigare forskning visar att en del grupper av unga är mer sårbara än andra och har mer erfarenheter av osäkert sex, sex mot sin vilja och sex mot ersättning. Vidare visar tidigare studier att unga inom följande sociala grupper: HBTQI+-personer, utrikesfödda unga, och unga med sämre socioekonomiska tillgångar, har sämre sexuell hälsa. Tidigare studier har inte utforskat hur jämlika förutsättningar har betydelse för hälsa i intersektionerna inom och mellan dessa sociala grupper. Lite är också känt om hur resurser som kan skapa mer jämlika förutsättningar i hälsa fördelas, sett ur ett intersektionellt perspektiv. SYFTE: Det övergripande syftet med denna avhandling är att utforska förutsättningarna för jämlik hälsa inom området sexuell och reproduktiv hälsa och rättigheter (SRHR) bland unga i åldern 16-29 år i Sverige. Mer specifikt analyseras intersektioner av sociala bestämningsfaktorer som skapar sårbarheter eller resurser i relation till SRHR. Detta övergripande syfte utforskas i fyra artiklar som berör sex olika SRHR-relaterade områden. Oskyddat sex, sex mot sin vilja och sex mot ersättning analyseras genom begreppet sårbarhet. Säkrare sex, sexuell hälsolitteracitet och nöjdhet med sexlivet analyseras genom begreppet resurser. METOD: Det empiriska materialet är hämtat från den stratifierade och randomiserade nationella befolkningsundersökningen ”Sexualitet och hälsa bland unga i Sverige” även kallad ”UngKAB15”. Undersökningen bygger på ett slumpmässigt urval av 29 950 ungdomar som drogs från Totalbefolkningsregistret och besvarades av 7 755 respondenter vilket gav en svarsfrekvens på 26 procent. De statistiska metoderna som använts i avhandlingen är deskriptiv statistik samt regressionsmodeller. RESULTAT: I artikel I presenteras ett deskriptivt intersektionellt schema som ger en visuell förståelse för hur en intersektionell analys kan identifiera utsatta positioner i relation till SRHR. Schemat visar exempelvis att intersektionen av sexuell identitet och kön spelar roll för vem som är sårbar för sex mot sin vilja. Resultaten visar att det finns ett behov av att både nationella och globala befolkningsbaserade undersökningar åtföljs av en intersektionell analys för att identifiera sårbara grupper i behov av SRHR-insatser. Artikel II visar på ett samband mellan unga människors kontroll över sin livssituation och förmåga att föreslå säkrare sex. Att känna kontroll över livet kan alltså definieras som en resurs för möjligheten att ha säkrare sex. Den intersektionella analysen visar på komplexiteten av hur kön och sexuell identitet påverkar säkrare sex då exempelvis unga killar med homo- och bisexuell identitet är mer resursstarka än heterosexuella killar. Kön kan inte ensamt förklara alla skillnader som finns i ungas resurser för säkrare sex. Artikel III visar ett samband mellan otillräcklig kunskap från skolbaserad undervisning i sexualitet, samtycke och relationer inom fem utforskade kunskapsområden (kroppen, sexuellt överförda infektioner, sexualitet, relationer och jämställdhet samt normer och hbt-perspektiv), och högre odds för att inte kunna ta hand om sin sexuella hälsa. Gruppen med högst överrisk för otillräcklig kunskap, och därmed sämre tillgång till hälsofrämjande resurser, återfinns bland unga HBTQI+-personer. Resultaten från artikel IV visar ett samband mellan att vara nöjd med sitt nuvarande sexliv och god hälsa. Nöjdhet med nuvarande sexliv är alltså en potentiell resurs för god hälsa. Denna resurs är dock ojämnt fördelad, eftersom killar och icke-binära unga är mindre nöjda med sitt sexliv än tjejer. SLUTSATS: Avhandlingen bidrar med fördjupad kunskap om hur intersektionalitet utgör ett användbart verktyg för att utforska förutsättningar till jämlik hälsa inom SRHR-området bland unga i åldern 16-29 år. Den intersektionella analysen har bidragit till att belysa ”grupper inom grupperna” och synliggöra mer eller mindre sårbara eller resursstarka positioner inom de hälsoutfallsområden som har utforskats. Användningen av intersektionell analys har underlättat identifieringen av en rad komplexa mönster och tydliggjort sårbarheter och resurser inom SRHR-området bland unga i Sverige. IMPLIKATIONER OCH FRAMTIDA FORSKNING: När intersektionalitet används som ett analytiskt verktyg påvisas ett komplext mönster av sårbarheter och resurser i SRHR-relaterade hälsoutfall. Det intersektionella perspektivet belyser att kön behöver analyseras tillsammans med andra sociala bestämningsfaktorer för att förstå komplexiteten i sårbarheter och resurser för hälsa. Sammantaget pekar resultaten på att global och nationell policy inom SRHR-området behöver uppdateras med kunskaper om intersektionalitet. Intersektionalitetsperspektivet behövs för att utveckla metoder för att hantera och inkludera små undersökningsgrupper, och därigenom, exempelvis, undvika att reproducera den binära könsnormen som baseras på kvinnor och män. Framtida forskning med intersektionell metod kan belysa den mångfald som finns i en befolkning och öka kunskapen om olika ”grupper inom gruppen”. Därmed stärks möjligheten att genom jämlika förutsättningar till hälsa nå det globala målet om ett hållbart och inkluderande samhälle i enlighet med Agenda 2030.
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| 49. |
- Schindele, Anna ChuChu, et al.
(författare)
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Vulnerability Analysis in Sexual and Reproductive Health and Rights (SRHR) : Indications of Intersecting Vulnerable Positions in a NationalSurvey Among Young People in Sweden
- 2022
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Ingår i: Sexuality Research & Social Policy. - : Springer Nature. - 1868-9884 .- 1553-6610. ; 19, s. 1034-1045
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionSexual and reproductive health and rights (SRHR) policies use gender as the foremost social determinant toexplain vulnerability in relation to SRHR among young people. Therefore, our aim was to explore intersecting vulnerablepositions within the three SRHR-related outcome areas: unsafe sex, sex against one’s will, and transactional sex, amongyoung people aged 16–29.MethodsThe data set is from a randomised, cross-sectional, and population-based SRHR survey conducted in Swedenin 2015, and the 7755 respondents imply a response rate (26%) in line with the power estimations. How gender intersectswith fve other social positions, i.e. social determinants (sexual identity, transgender experience, perceived economy, beingforeign-born, and social welfare recipiency), was explored through a stepwise descriptive intersecting vulnerability analysisexemplifed through three outcome variables: unsafe sex, sex against one’s will, and transactional sex.ResultsGender intersects with other social determinants and creates vulnerable positions in SRHR-related outcomes. Themost vulnerable positions within each of the three outcome variables were the following: (1) for unsafe sex: being a manand homosexual; (2) for sex against one’s will: being a woman and bisexual; and (3) for transactional sex: being a man andhaving transgender experience.Conclusions Despite limitations, the descriptive intersecting vulnerability analysis indicates how gender intersects withother social determinants and generates multiple vulnerable positions in relation to SRHR.Policy ImplicationsThe results can be of interest in future studies on vulnerability and inform policies that intend to fulflthe intention of leaving no one behind, as stated in the Agenda 2030.
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| 50. |
- Schindele, Anna ChuChu, et al.
(författare)
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Vulnerability Analysis in Sexual and Reproductive Health and Rights (SRHR) : Indications of Intersecting Vulnerable Positions in a NationalSurvey Among Young People in Sweden
- 2022
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundThe UN policies on global sexual and reproductive health and rights (SRHR) use gender as the foremost social determinant to explain vulnerability in relation to SRHR among young people. The Agenda 2030 explains SRHR only in relation to girls and women. Can we find new ways to analyse and discuss vulnerability and resources in SRHR. Our hypothesis is that intersectionality might be a useful tool. AimThe aim is as to explore intersecting vulnerable positions within the three SRHR related outcome areas; unsafe sex, sex against one’s will and transactional sex , among young people aged 16 29, through the development of a stepwise descriptive intersecting vulnerability analysis. MethodsThree outcome variables from the survey: 1. unsafe sex,2. sex against one’s will3. transactional sex Cross tabulations of outcome variables (1-3) stratified by gender andthe intersection of five other social determinants:1. gender*sexual identity2. gender*transgender experience3. gender*economy4. gender*foreign born5. gender*social welfare recipiency ResultsThe descriptive intersecting vulnerability analysis visualise how gender intersects with five other social determinants and how this generates vulnerable positions within the three outcome areas: unsafe sex, sex against one’s will and transactional sex. Vulnerable positions are complex and different in most of the three outcome areas. Intersectionality is a useful tool for vulnerability analysis in SRHR.
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