| 1. |
- Afua Quaye, Angela, et al.
(författare)
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Children's active participation in decision‐making processesduring hospitalisation : An observational study
- 2019
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Ingår i: Journal of cilinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 28:23¨24, s. 4525-4537
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: The aim was to explore and describe the child's active participationin daily healthcare practice at children's hospital units in Sweden.Objectives: (a) Identify everyday situations in medical and nursing care that illustratechildren's active participation in decision‐making, (b) identify various ways of activeparticipation, actual and optimal in situations involving decision‐making and (c) explorefactors in nursing and medical care that influence children's active participation indecision‐making.Background: Despite active participation being a fundamental right for children, theyare not always involved in decision‐making processes during their health care. Therestill remains uncertainty on how to support children to actively participate in decisionsconcerning their health care.Design: A qualitative study with overt, nonparticipant observations fulfilling theCOREQ checklist criteria.Methods: Observations of interactions between children aged 2 and 17 years withboth acute and chronic conditions, their parents, and healthcare professionals wereconducted at three paediatric hospitals in Sweden. The Scale of Degrees of SelfDetermination was used to grade identified situations. The scale describes five levelsof active participation, with level one being the least and level five being the mostactive level of participation. Normative judgements were also made.Results: Children's active participation was assessed as being generally at levels fourand five. Children demonstrated both verbal and nonverbal ways of communicationduring decision‐making. Findings indicated that children's, parents' and healthcareprofessional's actions influenced children's active participation in decision‐makingprocesses involving healthcare.Conclusions: Healthcare professionals specialised in paediatrics need to embrace botha child perspective and a child's perspective, plan care incorporating key elements of achild‐centred care approach, to ensure children's active participation at a level of theirchoosing.
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| 2. |
- Afua Quaye, Angela, et al.
(författare)
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How are children’s best interests expressed during their hospital visit? : An observational study
- 2021
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 30:23-24, s. 3644-3656
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To describe ways in which children's best interests were observed to be expressed in paediatric settings during their hospital visit. Background: The best interests of the child are embodied in national and international legal systems, although the definition remains problematic. The child's limited autonomy mandates duty bearers to have both a child perspective and the child's perspective when considering what the best interest of the child entails in care situations. Design: A qualitative descriptive study with overt, non-participant observations fulfilling the COREQ criteria. Methods: Thirty-two observations of interactions between children aged 2 to 17 years with both acute and chronic conditions, their parents and healthcare professionals were conducted at three paediatric hospitals in Sweden. Inductive and abductive reasoning were used in the content analysis of data, which followed the identification, coding, categorising and abstraction of observed patterns of the best interest of the child. Results: Findings reveal facilitating and obstructing factors for the child's best interests to be safeguarded in healthcare situations. Children were guided in or hindered from exercising their competence. The observations showed a variation in actions taken by both parents and healthcare professionals to safeguard the best interests of the child. Conclusions: Determining the best interest of the child requires a case-by-case basis, as it is context-dependent, situational, flexible and dependent on all actors involved and actual decisions made. Relevance to clinical practice: Healthcare professionals’ actions can facilitate or obstruct observed expressions of the child's best interest. It is essential to enhance healthcare professionals’ communication skills, knowledge awareness and continuing education about the rights of children receiving healthcare services. Reflections and discussions on how to protect the best interests of children may help healthcare professionals to uphold children's best interest in daily clinical practice.
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| 3. |
- Bogg, Lennart, et al.
(författare)
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Thailand and Sweden as welfare regimes : examples from the healthcare sector
- 2014
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Konferensbidrag (refereegranskat)abstract
- The characteristics of a welfare state is largely related to social justice and welfare reforms. This is mainly in the form of legislation, economic transfers and services that help to ensure that all citizens receive a basic economic security and access to services such as health care and nursing. A key factor for this is a country's economy and political will. In Thailand, there was a strong economic growth during the 1970s. The corresponding development in Sweden took place in the mid 1940's. Health and welfare is the main area of collaboration between the Ministry of Health in Thailand and Mälardalen University. The aim of this study is from a welfare perspective, a comparison of the similarities and differences in the basic elements of the health care systems in Thailand and Sweden.The study is based on analysis of national policy documents from Thailand and Sweden as well as from United Nations Agency.Both countries emphasize health and welfare from a social rights perspective in constitutions and other laws. E.g. the Thailand Constitution of 2007 states that a person shall enjoy an equal right to receive standard public health service, and the indigent shall have the right to receive free medical treatment from State's infirmary. The Swedish Constitution recognizes that the personal, economic and cultural welfare should be the fundamental goal of public activity through, among other things promote social care and social security, and good conditions for health. In the Swedish Health Care Act of 1982, the goal is a good health and care on equal terms for the entire population.Both Thailand and Sweden have a national system of Universal Health Coverage (UHC), which is defined according to World Health Organization (WHO) as ensuring that all people can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.In terms of selected indicators shows for the year 2012 that the Total health expenditure (THE) % of Gross Domestic Product (GDP) amounts in Thailand 4% and 10% in Sweden, general government expenditure on health as % of GDP are 3% resp. 8%, prevention and public health services are 9 resp. 4%, physician density per 1,000 population 0.3 resp. 3.9. The proportion of beds at public/private hospitals are 78/21% resp. 99/1%.The example from the health care system shows that the two countries have legislation that emphasizes health as a social right and a public financing of health care. In terms of specific indicators, there are wide variations in terms of costs to society and the individual including prevention and public health services, access to doctors and proportion of beds in public and private hospitals.
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| 4. |
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| 5. |
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| 6. |
- Cederbom, Sara, et al.
(författare)
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The importance of a daily rhythm in a supportive environment- promoting ability in daily activities among older women livingalone with chronic pain
- 2014
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 36:24, s. 2050-2058
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to explore how older women living alone with chronic musculoskeletal pain, describe their ability in performing activities in everyday life and what could promote their ability in activities in everyday life as well as their perceived meaning of a changed ability to perform activities in everyday life. Method: Qualitative interviews were conducted with 12 women, and an inductive content analysis was used. Results: The results showed the importance of a daily rhythm of activities. Activities included in the daily rhythm were socializing with family and friends, physical activities, doing own activities as well as activities supported by relatives and the community. The activities described by the women also promoted their ability in activities in everyday life. Other findings were the women's perceived meaning of being independent and maintaining that independency, along with the meaning of accepting and adapting to a changed life situation. Conclusion: This paper concludes that it is important to be sensitive of individual needs regarding the daily rhythm of activities when health-care professionals intervene in the activities in everyday life of older women living alone, promote the women's independency, and enable them to participate in the community.
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| 7. |
- Choowong, Jiraporn, 1971-
(författare)
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Barriers, Enablers and challenges in the practice of directly observed treatment for tuberculosis patients in a local Thai community
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Tuberculosis (TB) has presented a challenge to the public health community in Thailand, especially as regards patient adherence to TB treatment. Direct observed treatment (DOT) is recommended for promoting patient adherence to TB treatment. There is good evidence that DOT can significantly increase the patient adherence to TB treatment. However, the implementation of DOT has complex relationships to socioeconomic factors and Thai context issues. The overall aim was (1) to obtain a deeper understanding of what happens when the DOT is practised in a local Thai community, and (2) to generate knowledge for improving the implementation of DOT, and thereby improve patient adherence to TB treatment.The empirical data were collected in Trang province, in the southern region of Thailand, between 2013 and 2015. The sample of study I consisted of five District TB Coordinators and five TB clinic staff from the public health sectors in rural and urban areas. Phenomenographic analysis was used. Study II: Five focus group discussions were conducted with 25 village health volunteers and six family members; manifest and latent content analysis was used for the analysis. Study III: Twenty TB patients were interviewed, using grounded theory methodology. Study IV: A mixed-method systematic review was accessed through databases. Data from the selected studies were extracted and synthesized using thematic analysis. The fear of stigma of TB patients was considered a significant barrier to the practice of DOT and adherence to TB treatment (studies I, II and III). Lack of TB knowledge and skills among DOT observers were revealed as barriers to the practice of DOT (studies I and II). At the same time, social facilitation and TB patients’ positive thinking and self-awareness were considered enablers of patient adherence to TB treatment (studies I and III). Another result is to provide an empowerment approach for DOT observers, who, in turn, will increase the empowerment of TB patients to achieve adherence to TB treatment (study IV).This thesis contributes a deeper understanding of the perspective of healthcare providers, DOT observers and TB patients when DOT is practised in a local Thai community. A challenge from these results is to provide an empowerment approach towards DOT observers. The results of this thesis will be useful for policy-makers who will consider strategies for improving the implementation of DOT and enabling patient adherence to TB treatment in the Thai context.
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| 8. |
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| 9. |
- Choowong, Jiraporn, et al.
(författare)
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Thai district Leaders' perceptions of managing the direct observation treatment program in Trang Province, Thailand
- 2016
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Ingår i: BMC Public Health. - : BIOMED CENTRAL LTD. - 1471-2458. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Background: Thailand is 18th out of the 22 countries with the highest tuberculosis (TB) burden. It will be a challenge for Thailand to achieve the UN Millennium Development target for TB, as well as the new WHO targets for eliminating TB by 2035. More knowledge and a new approach are needed to tackle the complex challenges of managing the DOT program in Thailand. Contextual factors strongly influence the local implementation of evidence in practice. Using the PARIHS model, the aim has been to explore district leaders' perceptions of the management of the DOT program in Trang province, Thailand. Methods: A phenomenographic approach was used to explore the perceptions among district DOT program leaders in Trang province. We conducted semi-structured interviews with district leaders responsible for managing the DOT program in five districts. The analysis of the data transcriptions was done by grouping similarities and differences of perceptions, which were constructed in a hierarchical outcome space that shows a set of descriptive categories. Results: The first descriptive category revealed a common perception of the leaders' duty and wish to comply with the NTP guidelines when managing and implementing the DOT program in their districts. More varied perceptions among the leaders concerned how to achieve successful treatment. Other perceptions concerned practical dilemmas, which included fear of infection, mutual distrust, and inadequate knowledge about TB. Further, the leaders perceived a need for improved management practices in implementing the TB guidelines. Conclusion: Using the PARIHS framework to gain a retrospective perspective on the district-level policy implementation of the DOT program and studying the leadership's perceptions about applying the guidelines to practice, has brought new knowledge about management practices. Additional support and resources from the regional level are needed to manage the challenges.
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| 10. |
- Choowong, Jiraporn, et al.
(författare)
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Thai people living with tuberculosis and how they adhere to treatment : A grounded theory study
- 2017
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Ingår i: Nursing and Health Sciences. - : WILEY. - 1441-0745 .- 1442-2018. ; 19:4, s. 436-443
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Tidskriftsartikel (refereegranskat)abstract
- To develop a conceptual framework of adherence to treatment among Thai people living with tuberculosis, a grounded theory approach was used. A purposive sample of 20 Thai people living with tuberculosis, aged from 23 to 85years, was interviewed. From the participants' perspective, a core category of social belonging was highlighted, with three categories of conditions connected: personal barriers, personal resilience, and social facilitation. Personal barriers encompassed fear of stigma, concealing the illness, and lack of knowledge and motivation to complete the treatment regime. Personal resilience encompassed positive thinking and self-awareness. Social facilitation encompassed the ease of access to health services, continuity in the health service's ability to choose a directly-observed therapy observer, and social support. This study contributes a deeper understanding of the perspective of Thai people living with tuberculosis with regards to adherence to tuberculosis treatment. It might improve how local healthcare workers provide tuberculosis care, and inspire them to tailor care to people living with tuberculosis in a local community to increase personal resilience and reduce stigma.
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| 11. |
- Couto, Maria Thereza, et al.
(författare)
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Drivers' and conductors' views of causes and prevention of workplace violence in the road passenger transport sector in Maputo city, Mozambique
- 2011
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 11:800
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundWorkplace violence (WPV) is an occupational health hazard in both low and high income countries. To design WPV prevention programs, prior knowledge and understanding of conditions in the targeted population are essential. This study explores and describes the views of drivers and conductors on the causes of WPV and ways of preventing it in the road passenger transport sector in Maputo City, Mozambique.MethodsThe design was qualitative. Participants were purposefully selected from among transport workers identified as victims of WPV in an earlier quantitative study, and with six or more years of experience in the transport sector. Data were collected in semi-structured interviews. Seven open questions covered individual views on causes of WPV and its prevention, based on the interviewees' experiences of violence while on duty. Thirty-two transport professionals were interviewed. The data were analyzed by means of qualitative content analysis.ResultsThe triggers and causes of violence included fare evasion, disputes over revenue owing to owners, alcohol abuse, overcrowded vehicles, and unfair competition for passengers. Failures to meet passenger expectations, e.g. by-passing parts of a bus route or missing stops, were also important. There was disrespect on the part of transport workers, e.g. being rude to passengers and jumping of queues at taxi ranks, and there were also robberies. Proposals for prevention included: training for workers on conflict resolution, and for employers on passenger-transport administration; and, promoting learning among passengers and workers on how to behave when traveling collectively. Regarding control and supervision, there were expressed needs for the recording of mileage, and for the sanctioning of workers who transgress queuing rules at taxi ranks. The police or supervisors should prevent drunken passengers from getting into vehicles, and drivers should refuse to go to dangerous, secluded neighborhoods. Finally, there is a need for an institution to judge alleged cases of employees not handing over demanded revenues to their employer.ConclusionsThe causes of WPV lie in problems regarding money, behavior, environment, organization and crime. Suggestions for prevention include education, control to avoid critical situations, and a judicial system to assess malpractices. Further research in the road passenger transport sector in Maputo City, Mozambique and similar settings is warranted.
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| 12. |
- Coyne, I., et al.
(författare)
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Centeredness in Healthcare : A Concept Synthesis of Family-centered Care, Person-centered Care and Child-centered Care
- 2018
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Ingår i: Journal of Pediatric Nursing. - : W.B. Saunders. - 0882-5963 .- 1532-8449. ; 42, s. 45-56
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Tidskriftsartikel (refereegranskat)abstract
- Background: Increasingly within healthcare, different kind of ‘centeredness’ are used to denote the focus of care which can create confusion for practitioners. Methods: A concept analysis was undertaken to identify the antecedents, attributes and relationship between family-, person-, and child-centered care. PubMed and CINAHL were searched from 2012 to 2017 and thirty-five papers were reviewed. Results: Both person- and child-centered care are focused on individuals, a symmetric relationship and the tailoring of care to individual needs while family- centered care is focused on the family as a unit of which the child is included. Person-centered care focuses on an adult person with autonomy, while the focus in child-centered care is the individual child as an own actor with rights but still close to a family. Conclusion: It appears at a conceptual level that the concepts of centeredness contain both similarities and differences. Finding ways to structure nursing and focus the care that respects a person's dignity and humanity is essential in healthcare and should be a major goal of health policy and health systems worldwide. Implications: The identification of the antecedents and attributes embedded in the concepts may help raise professionals’ awareness of the different foci and how this will influence one's practice. There is a need to recognize strengths and weaknesses of the centeredness in different settings and environments. Furthermore, it is important to know which approach to apply within different situations so that quality care is enabled for every person, child and family.
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| 13. |
- Coyne, Imelda, et al.
(författare)
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Reframing the focus from a Family-centred to a child-centred care approach for children's healthcare
- 2016
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Ingår i: Journal of Child Health Care. - : SAGE Publications. - 1367-4935 .- 1741-2889. ; 20:4, s. 492-502
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Tidskriftsartikel (refereegranskat)abstract
- In this article, we argue for a conceptual move from family-centred care (FCC) to a child-centred care approach and the implications for clinical nursing practice. Firstly, we argue that the parents and professional dominance constructs an asymmetric relationship towards the child, which may take away the focus from the child; Secondly, we need to renew efforts to promote the fundamental principles of protection, promotion and participation rights for children and young people according to the United Nations Convention on the Rights of the Child declaration and thirdly, we need to strengthen the child’s perspective and to view the child as an agent representing own experiences and wishes to be respected and negotiated.
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| 14. |
- Finnman Grönaas, Johannes
(författare)
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Preschool staff’s working conditions and professional well-being in contexts with high proportions of early second language learners
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis explored the working conditions and professional well-being of preschool staff in Sweden, particularly in settings with a high proportion of early second language learners (L2 learners). The thesis is timely and significant, considering the growing diversity in Swedish preschools and the increasing presence of L2 learners. The research problem is rooted in the unique societal mission of preschool staff, who are pivotal in introducing young children to the Swedish education system and fostering their development and care. They also have a compensatory mission to support children who have less favourable conditions than other children. However, there are indications that the preschool staff are working in a vulnerable context. Preschool staff are among the occupational groups in Sweden exhibiting among the highest frequency of sick leave and are characterized by a significant staff turnover. The preschool staff has also experienced changes within their organisation. Concurrently, it remains unknown how working in groups with a high proportion of L2 learners (L2 groups) affects the preschool staff. The thesis aimed to understand the specific working conditions in L2 groups and how these conditions impact the professional well-being of preschool staff, defined as the perception of doing a professional and correct job, which included adhering to the curriculum and maintaining positive relationships with children, organisational commitment, and job satisfaction.The theoretical framework that guided this research was the bioecological systems theory and the Job Demands-Resources (JD-R) model. This framework helped to understand the overall social interactions and working context of the preschool staff, as well as to categorise and define psychosocial working conditions. It emphasises the interplay between job demands, job resources, and professional well-being. The thesis adopted an exploratory sequential design, initially employing mainly qualitative inductive interviews (Study I and II) to map the uncharted territory of the preschool working context, its social interactions, and working conditions in L2 groups. This was followed by a deductive, analytical phase using questionnaires in cross-sectional studies (Study III and IV).Study I adopted an exploratory sequential mixed-methods design. It explored the preschool staff’s support of children’s engagement in L2 groups, combining qualitative content analysis and independent T-tests. In individual interactions with children, the preschool staff aimed to establish closeness and acknowledge each child's presence. In these respects, no notable differences were observed among preschool staff across different groups. However, disparities emerged in group interactions with children. Preschool staff working in L2 groups encountered challenges in managing routines, imparting values, and facilitating peer learning among children.Study II focused on preschool staff's experiences of their working conditions in L2 groups, utilising qualitative content analysis based on interviews. Preschool staff working in L2 groups encountered a context that was more complex and challenging compared to their counterparts in L1-groups. This increased complexity primarily stemmed from a lack of adequate organisational resources, difficulties in establishing professional relationships, and constrained opportunities to effectively utilize their educational background and work-life experience. These layers of complexity were experienced to challenge their professional well-being.Study III utilised a cross-sectional design. It used Structural Equation Modelling (SEM) to examine preschool staff responsiveness and child engagement in relation to child behaviour difficulties and staffing. Behavioural difficulties and lower levels of engagement, characteristics associated with L2 children, were found to be negatively associated with the responsiveness of the preschool staff. Conversely, the responsiveness of the preschool staff exhibited a positive association with child engagement.Study IV was a cross-sectional questionnaire study. It employed random forests, and quasi-Poisson regression analysis to identify which working conditions predicted preschool staff’s professional well-being in L2 groups. The study extended the analysis from the qualitative phase to a quantitatively analysed context. It was predominantly the job resources, particularly the support from the preschool staff’s principal and colleagues, that most confidently predicted professional well-being. In contrast, job demands such as role conflicts and quantitative demands were less significant predictors. Additionally, individual factors, including formal education and work-life experience, did not significantly predict professional well-being. Likewise, structural factors such as the proportion of L2 learners also did not predict professional well-being.The findings of these studies highlight the complexity of working conditions in L2 groups and their relationship to professional well-being. They suggest that professional well-being is influenced by a balance of job demands and resources, the quality of relationships with children and their caregivers, and the ability to navigate organisational changes and diversity management effectively. The thesis underscores the need for policy and practice changes to support preschool staff in L2 groups, including enhanced formal education in diversity management, and increased organisational support to reduce job demands and bolster job resources. The proportion of L2 learners itself was not a significant predictor of professional well-being in any study, however. In conclusion, this thesis contributes to a deeper understanding of the unique challenges faced by preschool staff in L2 groups and offers insights for enhancing their professional well-being, which is crucial for the quality of early childhood education and care in multicultural settings.
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| 15. |
- Finnman Grönaas, Johannes, 1989-, et al.
(författare)
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Swedish preschool staff’s experiences of their working conditions in child groups with high proportions of early second language learners
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Preschool staff in general face challenging work conditions, contributing to high turnover and sick leave. This issue may be more complex for staff working in groups with high proportions of early second language learners (L2-groups), compared to those working in groups with a majority of first language learners (L1-groups). Yet, studies focusing on this issue are scarce. This study aimed to explore and describe the organizational and psychosocial work conditions experienced by staff in L2-groups. Through interviews with individual staff and workgroups, followed by content analysis, three themes emerged: perceiving organizational conditions, establishing professional relationships, and using competence. Staff in L2-groups experienced a context that was more complicated and demanding compared to those in L1-groups. This was primarily due to insufficient organizational resources, challenges in establishing professional relationships, and limited ability to use their education and experience effectively. These challenges compromised their professional well-being, and by extension, their psychological and physiological well-being. Addressing these issues necessitates additional resources and a nuanced understanding by policymakers of the unique challenges faced by staff in L2-groups.
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| 16. |
- Finnman, Johannes, et al.
(författare)
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Challenges to Relational Commitments of Preschool Staff in Supporting Children in Contexts with a High Proportion of Early Second Language Learners in Sweden
- 2023
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Ingår i: Early Education and Development. - : Informa UK Limited. - 1040-9289 .- 1556-6935. ; , s. 1-19
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Tidskriftsartikel (refereegranskat)abstract
- PurposeUsing COR theory to study developments of health and other key resources in self-employed workers in Sweden over 6 years, this study: (1) explored whether the heterogenous group of self-employed workers contained subgroups with different health trajectories, (2) investigated whether these were more typical for certain individuals (with respect to age, gender, sector, education, employment status), and (3) compared the different health trajectories regarding resource development in mental well-being, business resources, employment status, work ability.MethodThe study used data from the Swedish longitudinal occupational survey of health (SLOSH) and included participants working as self-employed or combiner (N = 2642).ResultFive trajectories were identified with latent class growth curve model analysis (LCGM). Two health trajectories with (1) very good, respective (2) good stable health (together comprising 78.5% of the participants), (3) one with moderate stable health (14.8%), (4) one with a U-shaped form (1.9%), and (5) one with low, slightly increasing health (4.7%). The first two trajectories flourish: they maintained or increased in all key resources and were more likely to remain self-employed. Trajectories three and five consist of those who fight to maintain or increase their resources. Workers in the U-shaped health trajectory show signs of fight and flight after loss in health and other key resources.ConclusionsStudying subgroups with different resource developments over time was suitable to understand heterogeneity in self-employed workers. It also helped to identify vulnerable groups that may benefit from interventions to preserve their resources.
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| 17. |
- Fioretos, Ingrid, et al.
(författare)
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Kommunikation med stöd av tolk
- 2014
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Ingår i: Kommunikation med barn och unga i vården. - Stockholm : Liber. - 9789147114061 ; , s. 201-213
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 18. |
- Flankegård, Gunilla, 1974-
(författare)
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Childhood functional constipation : Parents' everyday life experiences
- 2022
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Functional constipation is the most common chronic disorder in childhood with a great impact on family life. Treatment focuses on the behavioural nature of the disorder with toilet training and laxatives, with the goal of daily stool passage without difficulties. Management of care is predominantly carried out at home by parents, making them key partners in the paediatric care.Aim: The overall aim of this thesis was to explore and understand childhood functional constipation through the experiences of parents.Design and method: This thesis comprise two studies based on a phenomenological research method and design with an inductive reflective lifeworld approach using qualitative individual interviews to gather data. A theoretical framework was used in the analysis to further elucidate the findings.Findings: Shame was the essential finding, providing the reason parents acted in certain ways and the result of the same actions. Study I showed that everyday life was put on hold due to the time and effort invested in the adaptations demanded by the constipation. This left the parents feeling lonely, guilty, and fighting frustrating battles as they tried to gain control by being always one step ahead. Study II showed that giving constipation treatment resulted in parents questioning their parental identity. Treatment needed to be affirmed, as doubt and second thoughts sometimes made parents give treatment against their own will as well as defying their child’s will, bordering on feelings of being abusive. The findings were interpreted in the light of theories of illness beliefs and good parenting beliefs, suggesting belief systems are the path into the parents’ feelings of shame. Re-evaluating the beliefs might diminish failure to adhere to treatment regimens.Conclusions: This project shows that functional constipation is like other childhood chronic illnesses in respect of its importance and impact on everyday family life. Shame is a prominent feature of functional constipation experiences. However, the shame felt might be mitigated by targeting and re-evaluating the belief systems that form the lifeworld of the parents and family.
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| 19. |
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| 20. |
- Fritz, Johanna, et al.
(författare)
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The complexity of integrating a behavioral medicine approach into physiotherapy clinical practice
- 2019
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Ingår i: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 35:12, s. 1182-1193
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Tidskriftsartikel (refereegranskat)abstract
- Introduction and Aim: The implementation of a behavioral medicine (BM) approach in physiotherapy is challenging, and studies regarding the determinants are sparse. Thus, the aim of this study was to explore determinants of applying a BM approach in physiotherapy for patients with persistent pain across the micro-, meso-, and macro-levels. Methods: A qualitative multiple-case study design was used. Data were collected from four cases through semi-structured interviews with physiotherapists (PTs), patients, and managers; observations of video-recorded treatment sessions; and reviews of local directives and regulations. Data were analyzed with inductive content analysis and cross-case analysis, followed by mapping to the domains of determinants at the micro-, meso-, and macro-levels within the Implementation of Change Model. Results: Similar determinants were found across the cases. At the micro-level, these determinants concerned the PTs’ ambivalence toward a BM approach, a biomedical focus, embarrassment asking about psychosocial factors, BM knowledge, skills for applying the approach, and self-awareness. Others concerned the patients’ role expectations of the PT, patients as active or passive agents in the treatment process, patients’ focus on biomedical aspects, and confidence in the PT. At the meso-level, support from managers and peers, allocation of time, and expectations from the organization were identified as determinants. No determinants were identified at the macro-level. Conclusion: The complexity of integrating a BM approach into physiotherapy clinical practice arises from multiple determinants functioning as both facilitators and barriers. By selecting strategies to address these determinants, the implementation of a BM approach could be supported.
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| 21. |
- Hanpatchalyakul, Kulnaree, et al.
(författare)
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Caring for addicted Clients by Swedish Community Social workers, Sweden
- 2012
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Ingår i: Journal of Nursing Science and Health. - Bangkok : Mahidol university. - 2320-1940. ; 35:3, s. 107-117
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore and describe the Swedish social workers’ experiences in caring for addicted clients in the middle-sized municipality with a population of about 130,000 inhabitants. Qualitative descriptive study was applied. Purposive sampling was used to recruit the participants. Seven Swedish social workers participated in the study. These participants had extensive experiences and were able to communicate in English. The structured interviews, field notes, and the tape recorder were used during data collection process during February 21 st to March 23rd 2011. Content analysis was used for data analysis. The results disclose that two themes emerged including ways of encountering and ways of caring. The first theme way of encountering, social workers encourage their drug addicted clients to sustain abstinence by using motivation talk and showing respect for human rights. In another theme, way of caring, social workers applied standardize methods in the caring process and collaboration between the health care and social welfare systems.
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| 22. |
- Harder, Maria, 1970-, et al.
(författare)
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ENCOUNTERING PARENTS IN THE PRIMARY HEALTH CARE CENTRE a balancing act between different perspectives and expectations
- 2019
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Konferensbidrag (refereegranskat)abstract
- Background: Primary Healthcare Centers (PHC) are the first instance to seek care for patients who are not acutely ill. Children between 0-18 years account for 23 % of all doctor visits at PHC. These children rarely arrive by themselves; they are accompanied by parents or guardians. Thereby the health care professionals (HCP) need to relate to two individuals in the care situation. Parents are a resource for their child, and they should be given the opportunity to participate with the child in caring situations. The care relation influences the outcome of the encounter between parent, child and HCP. Aim: To describe HCP' reflections about the encounters with parents seeking care for their children at the PHC. Method: A qualitative content analysis with inductive approach was used. The analyzed material consists of HCP's reflections derived from a prior research project regarding children's involvement. Results: Encountering parents who seek care for their children at PHC means that HCP's in these care situations balance between different perspectives and expectations. This balance includes reflections that are described as: To have beliefs about parent's perceptions and expectations; To encounter parents and children as a unit and unique individuals and To guide parents. Conclusion: The prerequisite for district nurses to create a caring relationship with parents and children in a care situation involves understanding and encountering parents’ and children’s perspectives. A caring relationship benefits the care situation, the child's health and parent's trust in the HCP's. Keywords Care relation, Health Care Professionals, Parents, Primary Healthcare Center, Qualitative content analysis, Reflections
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| 23. |
- Harder, Maria, et al.
(författare)
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Exploring three-year-old children in a primary child health care situation
- 2009
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Ingår i: Journal of Child Health Care. - : SAGE Publications. - 1367-4935 .- 1741-2889. ; 13:4, s. 383-400
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Tidskriftsartikel (refereegranskat)abstract
- In the Swedish Primary Child Health Care (PCHC) children participate in regular health visits. In these visits children as actors demonstrate their subjective maturity through bodily and verbal expressions. The aim of this study was to explore three-year-old children's expressions when they take part as actors in a PCHC situation. An explorative design with a hermeneutic approach and video observations was used. Twenty-nine children participated. The findings exhibit a variation of expressions in the situation conceptualized as actions in a progression of states: from a state of getting ready to a state of being ready and further to a state where the child strengthens their own self. This progression is dynamic and coloured with the states of not being ready or of being adverse. The conceptualization of children's expressions can contribute towards encouraging nurses' sensitivity when inviting and guiding children in PCHC situations.
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| 24. |
- Harder, Maria, et al.
(författare)
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Five-year-old Children's Tuning-in and Negotiation Staregies in an Immunization Situation
- 2011
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Ingår i: Qualitative Health Research. - : SAGE. - 1049-7323 .- 1552-7557. ; 21:6, s. 818-829
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Tidskriftsartikel (refereegranskat)abstract
- In this article, we have explored 5-year-old children's expressions when they as actors took part in an immunization situation in the Primary Child Health Care (PCHC) service in Sweden. Although children's health and development are the main concern in the PCHC service, their perspectives in such a setting have not been explored fully. To capture children's perspectives we used a hermeneutic design and video observations. The findings revealed children as competent and active participants, contributing to the construction of the PCHC situation in mutuality with the nurse and the parent. The conceptualization of children's expressions and actions revealed how they influenced and dealt with a PCHC situation by using strategies of tuning-in, affirmative negotiation, and delaying negotiation. Understanding children's actions will assist nurses to act with sensitivity when they encounter and support children.
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| 25. |
- Harder, Maria, 1970-, et al.
(författare)
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Four year old children's negotiation strategies to influence and deal with a Primary Health Care situation
- 2013
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Ingår i: Children & society. - : Wiley. - 0951-0605 .- 1099-0860. ; 27:1, s. 35-47
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden, children’s health and development are promoted through Primary Child Health Care (PCHC) visits. The children participate in these visits from their own perspective through bodily and verbal expressions. This study explores four-year-old children’s expressions when they as actors take part in a PCHC situation. The conceptualisation of the children’s expressions reveals various actions that exhibit their affirmative and delaying negotiation strategies to influence and deal with these situations. For PCHC nurses, these findings may encourage to view children as negotiating participants and inspire to sensitivity when inviting children and guiding them through health visits
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| 26. |
- Harder, Maria, et al.
(författare)
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Four year old Children’s strategies of negotiation when they are holding a Primary Child Health Care situation
- 2009
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Konferensbidrag (refereegranskat)abstract
- Four year old Children’s strategies of negotiation when they are holding a Primary Child Health Care situationThe Swedish Primary Child Health Care (PCHC) is assigned to promote children’s (age 0-5) health and development through regular health visits. A child’s first year involves several health checkups, then planned health visits take place at 3, 4 and 5,5 years of age. These health visits is a part of a monitory program to examine the child’s speech development, motor and cognitive functions. During the health visit the child and the parent will meet a PCHC nurse. Recently, the child’s perspective as an actor in the health visit was explored. The result demonstrated how three year old children exhibit various actions in a progression of states. The child progress from a state of getting ready to a state of being ready and further to a state where the child strengthens the own self. This progression is dynamic and coloured with the states of not being ready or of being adverse. The aim of present study is to describe the four year old children’s strategies when they are holding a PCHC situation. The study has an explorative design with a hermeneutic approach and video-observations are used. Twenty-nine children participate and the selection is strategically. Informed consent was gained in writing from all children, parents and nurses. The findings exhibit how the children use various strategies of negotiation when they are holding a PCHC situation. Illuminating children’s perspective by conceptualizing their expressions and strategies may contribute towards encouraging the PCHC nurse’s sensitivity when inviting and guiding children in the health visit.
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| 27. |
- Harder, Maria, 1970-, et al.
(författare)
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Health care professionals’ perspective on children’s participation in health care situations : encounters in mutuality and alienation
- 2018
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor and Francis Ltd.. - 1748-2623 .- 1748-2631. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Encounters between health care professionals, parents and children in health care services for children are complex as these encounters involve the various perspective and understanding of each person involved. The aim of the study is to describe health care professionals’ understanding of significant encounters with children and parents to uncover the meaning of participation. Method: A qualitative descriptive design was applied. The health care professionals’ narratives (n = 35) of their significant encounters with children were interpreted from the perspective of participation. A phenomenological-hermeneutical approach was used in the analysis. Results: The findings show children’s participation as a dynamic movement in mutuality and alienation which can vary within a situation or between different situations involving the same persons. The movement can occur in mutuality and or in alienation depending on what or towards whom the persons direct themselves. Understanding participation as a movement in health care situations is useful in supporting children’s opportunities to participate from their own perspective and deal with health care examinations. Conclusion: The outcome of a situation can never be predicted. Still, professionals can be aware of their actions in encounters with children.
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| 28. |
- Harder, Maria, et al.
(författare)
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Hur uttrycker små barn sin delaktighet vid hälsobesök och i vårdsituationer?
- 2009
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Konferensbidrag (refereegranskat)abstract
- Hur uttrycker små barn sin delaktighet vid hälsobesök och i vårdsituationer?Att ha möjlighet att ge uttryck för sitt perspektiv i alla situationer innebär att få vara delaktig vilket hör till ett barns rättigheter. Att fånga barns perspektiv vid ett hälsobesök inom Barnhälsovården eller i en vårdsituation är att ge barnet möjlighet att uttrycka sin kompetens och att göra sin röst hörd. Barn uttrycker sitt perspektiv med kropp (gester, ansiktsuttryck och kroppsrörelser) och röst (tal, ljud). För små barn som ännu inte utvecklat språkets förmåga fullt ut är kroppen viktigt redskap i interaktion med andra. Med sin kropp visar barnet sina intentioner och handlar därefter vilket också påverkar andra i samma situation. Barnets mognad och erfarenheter avgör med vilka uttryck barnet agerar situationsanpassat. Vi har använt videoobservationer för att upptäcka barns uttryck när de deltar i aktiviteter inom hälsobesök eller i vårdsituationer. Dessa har analyserats för att söka förståelse utifrån barnets perspektiv. De varierande uttryck som treåriga barn visade i en hälsobesöksituation formade deras handlingar i en progress av olika tillstånd. När barnet inbjuds av sjuksköterskan att delta i en aktivitet rörde det sig från ett tillstånd att göra sig redo, till att vara beredvillig, och vidare till ett tillstånd där det bekräftade sig självt. I denna progress visade sig även tillstånd då barnet inte var redo eller var avogt inställd. I vårdsituationer med treåriga barn visade barnen uttryck som formade en progress av engagemang på varierande sätt. Efter att ha fått någon form av inbjudan till en aktivitet visade barnen vaksamhet. Denna vaksamhet övergick vidare antingen till ett nyfiket engagemang eller till ett engagemang av följsamhet. Efter inbjudan och visad vaksamhet med fortsatt misstro mot aktiviteten kunde dock sjuksköterskan och/eller förälder påtvinga barnet till att visa ett motsträvigt engagemang vilket ibland övergick till att barnet visade resignation. Att tydliggöra barns uttryck, handlingar, tillstånd och engagemang i olika situationer inom hälso- och sjukvård kan medverka till att utveckla vårdpersonalens lyhördhet för vad som är barnets perspektiv i sitt arbete för att se till barnets bästa, vilket är intentionen för hur konventionen om barns rättigheter förverkligas och implementeras.
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| 29. |
- Harder, Maria, et al.
(författare)
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Preschool children's expression of participation in Primary Child Health Care
- 2008
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Konferensbidrag (refereegranskat)abstract
- Preschool children's expression of participation in primary child health careIntroductionAccording to The Convention on the Rights of Child children have the right to have their voice heard and to participate in situations that involve them.Aim of the studyThe aim of this study was to explore and describe the expression of participation of 3-year old children during their annual primary health care visit.MethodsThe study employed qualitative research design using video-observation, and focused on the actions of twenty-nine 3-year olds in their interaction with the nurse. The varying expressions of the children were captured using hermeneutic analysis.ResultsThe findings demonstrate how 3-year old children prepare themselves for particiaption prior to their health care visit. They arrange their bodies in different positions, ask questions, seek contact with their parent or are absorbed in their thoughts. The children then direct their attention towards the health care activity, by using bodily and/or spoken expressions they respond to the nurse´s invitations. When the children have replyed to the invitation they confirm them self. Findings also show children´s expressions of unpreparedness and reluctance in the health care situation.Conclusion / discussionChildren’s participation occupies either all or part of the body and bodily expressions replace each other in a rapid progression. Children´s spoken expression strengthens their bodily expression.Practical relevanceStudying pre-school children’s expressions in the child health care environment can contribute to promote their participation in their interaction with nursing staff.Research implicationsThis research project will continue by studying the expression of perceived participation of children at 4 and 5,5 years of age during their annual primary health care visit.ReferencesAllmark, P. (2002). The ethics of research with children. Nurse researcher, 10 (2), 7-20.Bronfenbrenner, U. (1979). The ecology of Human Development. Cambridge, Mass. Harward university press.FA, Ministry for Foreign Affairs, (1989). The Convention on the Rights of the Child.Fraser, S., Lewis, V., Ding, S., Kellet, M. & Robinsson, C. (2004). Doing research with children and young people. London: Sage Publications.Hammersley, M. & Atkinson, P. (1995). Ethnography. Principles in Practice. London: RoutledgeMinistry for Health and Social Affairs. (2005). Mötet med barnet. Barnkompetens inom hälso-och sjukvården. 2005.031National Board of Health and Welfare. (1991). Allmänna råd från socialstyrelsen 1991:8. Hälsoundersökningar inom barnhälsovården. Stockholm: Allmänna förlaget.Schutz, A. (1967). The phenomenology of the Social World. Evanston: North-western Univ. Press.
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| 30. |
- Harder, Maria, et al.
(författare)
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Preschool children's expressions of engagement in Primary Child Health Care
- 2008
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Ingår i: Archives of Disease in Childhood. ; , s. 114-
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Konferensbidrag (refereegranskat)abstract
- Preeschool children’s expressions of engagement in primary child health careChildren have their right to give their voice and participate in situations which they are engaged in, according to The Convention on the Rights of Child. The aim of this study was to explore and describe 3 year old children’s expressions of engagement during annual child health care visit.A qualitative research design with video-observations was used. Twenty-nine 3 year old children’s actions were focused when interplaying with the nurse. A hermeneutic analysis was carried out to grasp the children’s varied expressions.The findings demonstrate how 3 year old children, when invited to the health care activity, are preparing themselves to readiness for engagement. They arrange their bodies in different positions, ask questions, seek contact with parent or are absorbed in thoughtfulness. Then the children direct their attention towards the nurse and/or the health care activity with spoken and/or bodily readiness. Children’s engagement occupies the whole body or separate parts of the body. Further, findings demonstrate how bodily expressions replace each other in a rapid process and how the same expressions can have different meaning depending on actual situation. The children’s spoken expressions: strengthen bodily expressions, are responding to nurses’ invitations or are spontaneously conversation.This research project will continue to study expressions of engagement and perceived participation of the children at 4 and 5,5 years of age at their annual primary child health care visits. To take preschool children’s engagement in primary child health care settings into consideration can contribute to promote their participation when interacting with the nurse.
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| 31. |
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| 32. |
- Harder, Maria, et al.
(författare)
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Undergoing an immunization is effortlessly, manageable or difficult according to five-year-old children
- 2015
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 29:2, s. 268-276
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Tidskriftsartikel (refereegranskat)abstract
- Background: To prevent diseases among children they regularly undergo immunizations. Previous research show different approaches available to facilitate immunization-procedures for children to protect them from harm. To complement this research and provide care suited for children, research recognizing their perceptions of undergoing such a procedure is needed. Aim: The aim of this study was to describe 5-year-old children's perceptions of undergoing an immunization. Method: A phenomenographic approach and analysis was used to describe the children's (n = 21) various perceptions. The data-collection was accomplished directly after the immunization to grasp the children's immediate perceptions. Drawings and reflective talks were used as they are considered as suitable methods when involving young children in research. The right to conduct research with children was approved by the appropriate research ethics committee and also by each child and the parents. Results: The findings show that children's perceptions of an immunization-procedure may vary from effortlessly, to manageable or difficult. Regardless of how the child perceive the immunization-procedure each perception embrace the children's descriptions of actors and articles in the situation, their feelings in the situation and also their actions to deal with the immunization. Nevertheless, these descriptions vary according to how the children perceive the immunization as effortlessly, manageable or difficult. Conclusion: Children's and adults' perceptions of medical procedures may differ and children need guidance, time and space to deal with them. Recognizing children's perceptions of undergoing an immunization contributes to the promotion of their right to be involved in their own health care and towards the development of child-centred care.
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| 33. |
- Harder, Maria, 1970-, et al.
(författare)
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Using video-technique to capture preschool children's participation
- 2007
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Konferensbidrag (refereegranskat)abstract
- USING VIDEO TECHNIQUE TO CAPTURE PRESCHOOL CHILDREN’S PARTICIPATIONExploring preschool children’s actions to reveal the way they participate in health care situations is a methodological challenge. This challenge lays in capturing children’s expressions, spoken words and body language. Using video technique during observation offers an opportunity to reveal small changes in children’s expressions that might be failed to secure when using the human eye solely. However, video observation is not only about pushing the ‘rec-button’. It requires both methodological and ethical considerations in advance: What is to be in focus during the video observation? What decides when each observation begins and ends? How much time must be devoted for fieldwork and complementary work? Further, the researcher needs to get informed consent from everyone involved. Constant reflexivity during the initial phase, video observations, transcriptions and analysis is also important as the researcher’s presence will influence the final outcome. When transcribing, the researcher’s predetermined focus guides the selection about what to transcribe. To accomplish a selection when transcribing is necessarily to not get lost in the gathered data. The opportunities to see the same sequence several times and to share the observations with a more experienced researcher can contribute to trustworthiness. Therefore, to describe and discuss video observation as a methodological issue is important. Video observations provide rich and thick information that can bring understanding to children’s participation in a detailed and varied way.
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| 34. |
- Isaksson, Kerstin, 1952-, et al.
(författare)
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Att granska ett forskarutbildningsområde : Exemplet hälsa och välfärd, Mälardalens högskola
- 2021
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Ingår i: Socialmedicinsk Tidskrift. - 0037-833X .- 2000-4192. ; 98:3, s. 467-478
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Tidskriftsartikel (refereegranskat)abstract
- I ett drygt decennium har det varit möjligt för statliga och enskilda högskolor i Sverige att ansöka om att få inrätta forskarutbildning inom ett specifikt område. Fram till 2020 har 38 tillstånd beviljats och åtta av dessa har koppling till området hälsa och/eller välfärd. Sedan läsåret 2012/13 finns vid Mälardalens högskola (MDH) forskarutbildning inom detta område. Syftet med denna artikel är att beskriva och diskutera en granskning av hur området hälsa och välfärd återspeglas i de första 15 avhandlingarna. En kvalitativ deduktiv innehållsanalys genomfördes samt en bibliometrisk undersökning av innehållet i avhandlingarnas introduktion och diskussion. Utifrån granskningen diskuteras resultatet men också hur den metodik som tillämpats kan vara relevant för granskning av avhandlingar även vid andra högskolor med ett specifikt forskarutbildningsområde.
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| 35. |
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| 36. |
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| 37. |
- Lännerström, Linda, 1974-, et al.
(författare)
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Nurses' experiences of managing sick-listing issues in telephone advisory services at primary health care centres
- 2013
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 27:4, s. 857-863
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Over the last decade Swedish health care has focused on improving the management of sick-listing issues. At primary health care centres sick-listing is mainly dealt with by the patient’s physician but when patients have requests related to sick-listing and contact the telephone advisory service nurses will be involved. The aim of this study was to describe nurses’ experiences of managing sick-listing issues in telephone advisory services in a primary health care setting.Methods: The study was a qualitative focus group study. Data collection was conducted in three focus group conversations in a county in central Sweden in 2009. The conversations were recorded, transcribed and analyzed using qualitative content analysis. The study included fourteen nurses, purposively sampled as having current experience of telephone advisory services at primary health care centres.Findings:The management of sick-listing issues was described by the nurses as Nurses Actions which were affected by Enabling conditions and Obstructing conditions. The Nurses’ Actions included making an assessment for appropriate action, making an appointment and/or giving information and guidance to the patient and/or monitoring patient’s rights. Enabling conditions included documentation, routines, supportive co-operation and training in insurance medicine. The obstructing conditions were related to patients’ expectations, co-operation with other professionals, lack of training and the nurses’ professional role.Conclusion: The nurses experienced stress and difficulties related to being gatekeepers and related to the act of balancing different demands from patients, co-workers and the organisation. This in combination with the lack of training caused the nurses to state that they did not want responsibility for managing sick-listing issues. Sufficient documentation, education, routines, support of and discussions with other professionals at the primary health care centre could be ways of improving nurses’ and other professionals’ management of sick-listing issues.
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| 38. |
- Mattsson, Janet
(författare)
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Uncovering pain and caring for children in the pediatric intensive care unit : nurses’ clinical approach and parent’s perspective
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: The thesis has a standpoint in a synthesis of caring science and educationscience from a clinical perspective. Children in a Pediatric Intensive Care Unit (PICU) are in an exposed position, dependent on nurses to acknowledge their needs. The alleviation of children’s pain has been investigated from various perspectives, but undertreated pain remains a problem in the PICU. There is a preponderance of empirical evidence pointing toward the role of nurses in uncovering children’s pain and suffering. How nurses interpret the child’s expressions and judge the clinical situation influences their actions in the clinical care. In a PICU, the basis for nurses’ concerns and interpretation of what is meaningful in the nursing care situation are formed by professional concern, workplace culture, traditions, habits, and workplace structures. This influences how parents interpret the meaning of care as well. Patricia Benner’s theory on clinical judgment forms a reference framework for this thesis. The assumption is that children need to be approached from a holistic perspective in the caring situation in order to acknowledge their caring needs. A nurse’s clinical education and insights allow for the possibility to enhance the quality of care for children and parents in the PICU.Aim: To uncover clinical concerns, from caring and learning perspectives, in caring for children in the Pediatric Intensive Care Unit (PICU) from nurses and parents perspective.Methods: Qualitative methods were used in all studies to unfold and explore the phenomena in the nurses’ and parents’ everyday clinical life world. In Papers I and II, a phenomenographic method was adopted. In Papers III and IV, an interpretive phenomenological approach was adopted.Findings: Nurses that have a holistic view of the child and approach the child from a multidimensional perspective, with a focus on the individual child and his/her caring needs, develop a clinical “connoisseurship” and meet the parents’ expectations of the meaning of care. The nurses express that it is only when they focus on the child that subtle signs of pain are revealed. The meaning of nursing care, in the ideal case, is a holistic care where all aspects are integrated and the child as a person has first priority.Conclusion: The meaning of caring and children’s needs must become elucidated to improve the cultural influence of what can be seen as good nursing care within the PICU.
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| 39. |
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| 40. |
- Osman, Fatumo, et al.
(författare)
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Perceptions of the use of khat among Somali immigrants living in Swedish society
- 2011
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 39, s. 212-219
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim of this study was to gain a better understanding of Somali immigrants’ perceptions of the use of khat living in Swedish society. Using khat is illegal in SwedenMethods: A phenomenographic design was used to capture different perception of using khat. Fourteen interviews were conducted with both men and women. The information was subjected to phenomenographic analysis.Findings: Perceptions of the habit of chewing khat among Somalis living in Sweden vary. The use of khat is perceived as a kind of food or as a drug. To use khat is perceived as having a physical impact on individual health, as well as an impact on social and family life. Using khat also has an impact on people’s time, because time is needed to indulge the habit. Furthermore, using khat is perceived as a medium for cultural and community cohesiveness. The Somalis prefered preventive measures in place to counter the use of khat in SwedenConclusions: The use of a phenomenographic design which captured the variation in perceptions of the habit of using khat among Somali immigrants’ living in Swedish society is helpful in guiding individual strategies in health promotion activities.
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| 41. |
- Ranheim, Albertine, et al.
(författare)
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Facilitating young children's participation in health care situations
- 2014
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Konferensbidrag (refereegranskat)abstract
- Facilitating young children’s participation in health care situations Background An initiative was given to perform a collaborative research project with health practices in Sörmland on facilitating young children’s participation in health care situations. Departing from workshop with healthcare professionals conveyed that it is an ambiguous challenge to be in care situations with children since each situation depends on its participants; the child, the parents and the professionals. These findings were used in reflective forums to integrate theory and practice to broaden the professionals’ awareness of the child’s perspective in care situations. The project is inspired by a clinical application research (CAR) design, where scientifically trained researchers work with health care professionals, building a team to exchange experiences related to data collection, interpretations and the applicability of the results.The use of research involves a process of learning as well as engaging beliefs and actions, and these questions are foundational for the practice of clinical care. Such approach aims at facilitating the use of research in clinical practice, to reduce the eventual gap between theory and its practical application. The overall aim of the project is to facilitate young children’s participation in their health care situations Method and Material The CAR design involves understanding, interpretation and application. This means reflecting on care situations and being confronted with assumptions from theoretical perspectives as well as training an openness and awareness in caring encounters. The team work is in a continued progress and will last during 2014. The data analysis will then proceed.Result :Some preliminary result will be presented about the process and outcome of the clinical application research Clinical implications: This study may contribute to the stock of knowledge regarding the implementation of an interactive communicative device with the purpose to facilitate young children’s participation in their health care situations.
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| 42. |
- Rooth, Hetty
(författare)
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All Parents in Focus : Governing parents and children in universal parenting training
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The thesis deals with power and control in public health interventions in Sweden using structured parental support programs. The aim is to visualize how parents and children's relationships are described and discussed in manuals and courses intended for all parents with children between the ages of 0 and 17 and how the children themselves describe in their family.By using theories of power and governing, the thesis aims to study how the parent-child relationship is regulated through normative discourses and power processes in selected parenting courses (Connect and ABC). The thesis also wants to give children a voice about their position in the family. The interest of the thesis is how preventive work, through structured courses, currently used in universal parenting training, can contribute to promote children’s health.Previous research on universal parenting training in Sweden is based primarily on health economic calculations and quantitative assessments of behavioural changes in children and parents. This thesis instead wants to study the values and methodology of parenting training programs and the children's experiences in their family when parents have participated in parenting courses. With a children´s rights perspective, the thesis also wishes to highlight the parenting support in relation to the children's situation.The thesis contains four qualitative studies. Two are conducted with discourse analysis (Study I and III) and two use content analysis (Study II and IV). Study I examines two public investigations from 1947 and 2008, both of which deal with child rearing, parenting and parenting education. Study II explores the contents of the course manuals of the Canadian Connect program and Swedish All Children in Focus (ABC) in relation to the UN Convention on the Rights of the Child. Study III examines how principles about parental skills and children’s actions are reflected in the parenting courses. Study IV describes children's experiences of being children in the families where the parents have participated in a parenting course.The findings in study I show that society's views on parents' relational ability in both investigations creates the prerequisite for acting politically for universal parenting training. The children's position is subordinate to adults in the investigations. Furthermore, in Study II, it appears that the content of both program manuals (Connect and ABC) is in accordance with Swedish public health policies, where parental ability can be seen as a protective factor for children's development. The study also shows that the courses can both restrain and promote children's participation. Study III shows that leaders at course meetings encourage parents to improve their parenting through self-control and conflict management. Parental capacity is seen as a determinant for children's development and health. In study IV, with children´s interviews, the children´s relate their views on the relationship with their parents and the children´s own relational ability.Throughout the thesis the findings show how an adult perspective is used to deal with conflicts and stabilize relationships in the family. An adult ambition to understand children and promote good relationships within the family is hampered by the concern of both society and parents for the parental child rearing ability. This concern can contribute to an uneven balance of power between adults and children. Preventive manual-based parenting training offers limited scope for children's influence in a health-promoting public health context. Children's experiences should thus be captured when society provides parenting support.
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| 43. |
- Rooth, Hetty, et al.
(författare)
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An Assessment of Two Parenting Training Manuals Used in Swedish Parenting Interventions
- 2017
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Ingår i: Children & society. - : Blackwell Publishing Ltd. - 0951-0605 .- 1099-0860. ; 31:6, s. 510-522
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden, all parents of children aged 0–18 years are entitled to attend free parenting courses as part of a national strategy presented by the Government in 2009. This broad parental support welfare strategy is expected to fulfil the intentions of the UN Convention on the Rights of the Child. In this study, two parenting training manuals were analysed: the Canadian Connect program, based on attachment theory, and the Swedish ABC program, based on social learning theory. The results indicate that the manuals use strategies that can both hinder and support children's rights, regardless of rhetoric of children's best interests. © 2017 John Wiley & Sons Ltd and National Children's Bureau
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| 44. |
- Rooth, Hetty, et al.
(författare)
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Being a child in the family : Young children describe themselves and their parents
- 2023
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Ingår i: Journal of Family Studies. - : Taylor & Francis. - 1322-9400 .- 1839-3543. ; 29:1, s. 1-14
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Tidskriftsartikel (refereegranskat)abstract
- This study explores how children describe their experiences of family interaction with parents who had taken part in parenting training. 11 children between five and nine years participated in semi-structured interviews which were analysed using a qualitative content analysis method. The children described themselves as active participants in family life, identifying strategies that they used to safeguard their subjective selves on one hand and to enhance communication with their parents on the other. The analysis displayed three main approaches in everyday life: withholding thoughts and hiding, extending limits for personal agency, and putting trust in their parents to guide and protect them in their stride. While handling these processes the children showed a willingness to take part in democratic family decisions by compromises and compliance. Towards their parents they expressed understanding and forbearance with adult shortcomings such as absentmindedness. Their reasoning involved issues of integrity and relational closeness. Conclusively, the children balanced their own selves with an undemanding respect for parental care and adult competence. The study contributes to awareness of and respect for how children position themselves as relational agents in a generational order. The results suggest that future research should further explore children’s perspectives on family life in a parenting training context. Children’s views should be drawn on to inform future developments in parenting training.
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| 45. |
- Rooth, Hetty, et al.
(författare)
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Competent parents with natural children : parent and child identities in manual-based parenting courses in Sweden
- 2018
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Ingår i: Childhood. - : Sage Publications. - 0907-5682 .- 1461-7013. ; 25:3, s. 369-384
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Tidskriftsartikel (refereegranskat)abstract
- This article analyses identity constructions in two manual-based universal parenting training programmes in Sweden, Connect (U) and All Children in Focus (ABC). The analysis was performed with discourse analysis of oral messages during parent training courses. The findings revealed that the parents’ subject positions altered between troubled and good while the children’s subject positions altered between ambiguous and natural in a confessional discourse of uncertainty and competence. Conclusively, pastoral power operated to support parental self-reflexivity and adult control in a process to improve parenting skills.
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| 46. |
- Rooth, Hetty, et al.
(författare)
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Trusted and doubted : Discourses of parenting training in two Swedish official inquiries, 1947 and 2008
- 2018
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 46:20_suppl, s. 59-65
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to analyse discourses of parenting training in official inquires in Sweden that explicitly deal with the bringing up of children and parental education and how the representations of the problems and their solutions affect parental subject positions in the early welfare state and at the onset of the 21st century. Method: We carried out a discourse analysis of two public inquiries of 1947 and 2008, drawing on theories about governmentality and power regimes. Tools from political discourse analysis were used to investigate the objectives of political discourse practices. Results: Both inquiries referred to a context of change and new life demands as a problem. Concerning suggestions for solutions, there were discrepancies in parents’ estimated need of expert knowledge and in descriptions of parental capacity. In a discourse of trust and doubt, the parents in 1947 were positioned as trusted welfare partners and secure raisers of future generations, and in 2008, as doubted adults, feared to be faltering in their child-rearing tasks. Conclusions: The analysis revealed how governmental problem descriptions, reasoning about causes and suggestions of solutions influenced parents’ subject positions in a discourse of trust and doubt, and made way for governmental interventions with universal parenting training in the 21st century.
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| 47. |
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| 48. |
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| 49. |
- Sitanon, Thongsouy, et al.
(författare)
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Parents health literacy and their experiences of participation in their child's care during hospitalization.
- 2014
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Konferensbidrag (refereegranskat)abstract
- Background. Parents’ health literacy is an important key factor that influences how they are able to understand their child’s health status and needs, and how to participate in the care when their child needs to be in hospital. Parents are the most important care givers, who facilitate ongoing growth and development of their children, giving protection and support. How well parents are able to care and support their child’s care will be influenced by their health literacy. Further, parents’ experiences of participation in their hospitalized child’s care are not investigated in Thailand, comparing with other international studies.The aim. The aim of this study is to explore parents’ health literacy and their experiences of participation in their child’s care during hospitalization. The study will be conducted in four pediatric units at Phrapokklao Hospital, a central hospital in Chanthaburi, Thailand.Method. A descriptive qualitative research design will be used. Thirty biological Thai parents, whose children stay in the pediatric units, will be interviewed. A demographic data sheet will be used to obtain background information on characteristics of the parents. A semi-structured interview guide with open-ended questions will be used. The questions include general questions to grasp parents’ health literacy, to specific questions experiences of participation in the child’s care. A content analysis, developed by Graneheim and Lundman, will be used. Ethical considerations have to be made according to informed consent and voluntarism. Consent is given by the Ethical committee in Chanthaburi Province, Thailand.Findings. During the conference preliminary results will be presented as generated concepts of understanding of the Thai parents’ health literacy, as well as generated categories of parents’ experiences of participation in the child’s care.Clinical implications. Health literacy and experiences of participation is cultural sensitive. Health care providers in different cultures need to understand parents’ health literacy to develop strategies to facilitate and improve their participation in the care of their children according to the rights in the Child convention.
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| 50. |
- Stalberg, Anna, et al.
(författare)
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Children's Right to Health through the Principles of Protection, Promotion, and Participation, from the Perspectives for Children, Parents, and Professionals : A Systematic Review
- 2024
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Ingår i: Child Care in Practice. - : TAYLOR & FRANCIS LTD. - 1357-5279 .- 1476-489X.
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Tidskriftsartikel (refereegranskat)abstract
- This systematic review aimed to identify how children's right to health, connected to the principles of protection, promotion, and participation, and from the perspectives of children, parents, and professionals in preschool, school, and healthcare has been empirically demonstrated by international scholars between 1989 and 2021. Following the standards of PRISMA-P, two searches, in 2018 and 2020, were conducted in seven databases. In total, 561 studies were found and after the screening process, which entails reviewing titles, abstracts, and full text-versions, 49 studies were finally included. A deductive qualitative content analysis, proposed by Elo and Kyngas, was performed. According to the findings, protection was demonstrated as Being protected from harmful acts and practices and being entitled to special care and assistance. Promotion was demonstrated as Possessing of resources and Receiving of services, and participation as Being heard and listened to and Being involved in matters of concern. Conforming to the findings, although presented separately, protection, promotion, and participation could be understood as interrelated concepts. In summary, children's right to health was demonstrated within two major fields: as the use of their own resources, and trust and as aspects provided by adults as support and safety. This is the first review of studies, published 1989-2021, identifying children's right to health through the perspectives of protection, promotion, and participation. During this period, children's right to health has mainly been demonstrated in studies from a healthcare context. All researchers, policymakers, health workers, and politicians should include children in all decisions that concern them, to increase their participation. As children's health is closely linked to their physical, social, and cognitive development there is a need for more studies exploring children's right to health in preschool and school contexts in which children spend their everyday life.
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