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Sökning: WFRF:(Schön Ulla Karin 1970 )

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1.
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2.
  • Schön, Ulla-Karin, 1970- (författare)
  • Kvinnors och mäns återhämtning från psykisk ohälsa
  • 2009
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The overall aim with this thesis is to describe and analyze women’s and men’s recovery processes. More specifically, the aim is to determine what women and men with experience of mental illness describe as contributing to the personal recovery process. The point of departure for the studies was 30 in-depth interviews conducted with 15 men and 15 women. The selection of interview subjects was limited to individuals who had been treated in 24-hour psychiatric care and diagnosed as having schizophrenia, psychosis, a personality disorder, or a bipolar disorder. Four studies have been carried.  Study 1 was a baseline article that examined what people in recovery from mental illness outline as facilitating factors to their recovery. The results that emerged from that study indicated areas for further analysis to condense the understanding of the recovery process. In study 2 the similarities and the differences in recovery described by women and men were examined. In Study 3 women’s and men’s meaning-making with reference to severe mental illness facilitate the recovery process were studied. The forth study explored how peer-support contribute to women’s and men’s recovery from mental illness. The results emphasize recovery from mental illness as a social process in which relationships play a key role in creating new identities beside the mental illness. For a majority of the participants meeting peers facilitated the recovery process. The participants described how peer support meant an end to isolation and became an arena for identification, connection, and being important to others. Throughout these recovery processes the impact of gender has been emphasized. The results from this thesis provide new insight into gender as an important factor in understanding the recovery processes. The results from the four studies emphasize the mental patient, the psychiatric interventions and the individual recovery strategies as being influenced by gender constructions.
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3.
  • Andersson, Peter, 1980-, et al. (författare)
  • Exploring stakeholder perspectives to facilitate the implementation of shared decision-making in coordinated individual care planning : [Utforskande av stakeholderperspektiv för att stödja implementeringen av delat beslutsfattande i samordnad individuell vårdplanering]
  • 2023
  • Ingår i: European Journal of Social Work. - : Routledge. - 1369-1457 .- 1468-2664.
  • Tidskriftsartikel (refereegranskat)abstract
    • This article explores conditions for implementing shared decision-making (SDM) in coordinated individual care planning (CIP) with individuals with complex mental health needs. SDM in CIP are described as central, although such user centred collaboration still remains to be realised. Research underlines the need for a changed way of working, where user expertise is valued and a balance of power is promoted. The aim of the present study is to investigate the conditions for implementing SDM in connection with CIP for and with people with mental illness. To better understand the context and conditions that can promote such an implementation, altogether 15 participants were interviewed in three regions in Sweden within the scope of a stakeholder analysis. Both hindering and supporting factors were identified with respect to an implementation process, such as staff turnover, differences in work culture and committed leadership. Further focus should be directed specifically towards professionals working more closely with CIP and towards in-depth analysis of the construct of culture in terms of implementation processes. 
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4.
  • Bromark, Kristina, et al. (författare)
  • Practitioners exploring intertwined challenges and possible solutions for user participation in social services
  • 2022
  • Ingår i: Nordic Social Work Research. - 2156-857X .- 2156-8588.
  • Tidskriftsartikel (refereegranskat)abstract
    • Despite a strong emphasis on user participation in social services, scientific knowledge on how to achieve these goals is limited. The aim of this study is to explore what social work practitioners identify as challenging in implementing user participation and what solutions they propose to be necessary to meet these challenges. Future workshops were applied, combining data from brainstorming processes and from the participants’ analytical work, identifying current obstacles and co-creating solutions. The workshops took place at the Personal Social Services section in a suburban area outside a large city in Sweden with 95 participants. The findings are discussed in relation to a model of participation, where creating openings, opportunities, and obligations are essential. The participants highlighted the need to strengthen commitment to user participation, increased access to knowledge and methods that enhance user participation, and support from management, with increased resources to ensure continuous development and maintenance. Practitioners must be able to engage in user participation, and actions need to be taken at all organizational levels. To overcome a complex and intertwined set of challenges, an intertwined set of solutions is required. 
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5.
  • Bromark, Kristina, 1973- (författare)
  • The user as a key actor in user participation : Exploring knowledge production in personal social services with a participatory approach
  • 2024
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The concept of user participation in social work is frequently debated. In Sweden, users are supposed to be active and involved in matters concerning them, a stance which is regulated in policy and law. The involvement of users in practice can be considered a form of knowledge production that can strengthen and develop users as well as the organizations. In practice, however, research shows that actual engagement, education or activation of users is difficult to attain and can be understood as a devaluation of user knowledge. The aim of this dissertation is to increase knowledge of how to understand and enhance the conditions for user participation in personal social services. To study this question, the dissertation focuses especially on young people’s participation in the context of out-of-home care. To explore user participation in personal social services, a participatory approach was applied. Data was gathered with young people and staff using participatory techniques as well as qualitative interviews. To explore challenges and possibilities with user participation, a future workshop was held with staff in personal social services (study I). This was followed by a co-design process in which staff, young people, and researchers collaborated on a support tool (study II), later to be implemented in practice (study III). The implementation process was explored by interviewing both staff and managers as well as a user representative (from a youth council). The co-design and implementation processes are problematized and discussed in the dissertation from a researcher’s perspective (study IV). The theoretical framework for understanding how users can be devalued as knowers is epistemic injustice. The assumption is that the role of a knower can shift, depending on social power and the structures in a context. The findings in this dissertation show that user participation is contingent on the distribution of power and responsibility and on perceptions of knowers and knowledge in practice. Although the general attitude towards user participation is positive, a reluctance in practice is revealed. It appears to be a challenge for staff to acknowledge the expertise of users, despite the fact that the users’ have the capacity and are willing to contribute with their knowledge. Work with user participation is identified as a team effort that requires actions at all levels of the organization as well as increased resources, leadership and a coherent understanding and agreement of the concept. A participatory approach to knowledge production with users is identified as a possible way to enhance epistemic justice and the inclusion of all relevant actors in activities and processes. The dimensions important to user participation can be acknowledged. For the dynamics to be maintained in a wider sense, however, an organizational infrastructure, with routines and methods, is necessary. To sustain epistemic justice in the implementation of user participation, a participatory culture with a solid and coherent understanding of user participation in practice is encouraged. A realization of user participation in practice requires a critical exploration of power and positions, systematic changes to infrastructure and transparency about roles and responsibility. 
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6.
  • Dahlqvist Jönsson, Patrik, 1974-, et al. (författare)
  • Service users' experiences of participation in decision making in mental health services
  • 2015
  • Ingår i: Journal of Psychiatric and Mental Health Nursing. - Chichester : Wiley-Blackwell. - 1351-0126 .- 1365-2850. ; 22:9, s. 688-697
  • Tidskriftsartikel (refereegranskat)abstract
    • Service user participation in decision making is considered an essential component of recovery-oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core category that emerged in the analysis described a 'struggle to be perceived as a competent and equal person' while three related categories including being the underdog, being controlled and being omitted described the difficulties of participating in decisions. The data analysis resulted in a model that describes internal and external conditions that influence the promotion of participation in decision making. The findings offer new insights from a user perspective and these can be utilized to develop and investigate concrete methods in order to promote user's participation in decisions.
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7.
  • Erlandsson, Sara, 1979-, et al. (författare)
  • Perceptions of participation: how nursing home staff and managers perceive and strive for participation of older residents : [Brukardelaktighet på äldreboenden – vad vill personal och chefer uppnå?]
  • 2023
  • Ingår i: European Journal of Social Work. - : Informa UK Limited. - 1369-1457 .- 1468-2664. ; 26:5, s. 815-827
  • Tidskriftsartikel (refereegranskat)abstract
    • User participation is increasingly emphasised in policies guiding social services. However, translating policy into practice is fraught with difficulties. The staff’s approaches to user participation are crucial for the users’ opportunities to participate in decision-making, particularly for users with extensive care needs and reduced autonomy. The aim of this article is to explore how nursing home staff and managers perceive the participation of older residents and what the implications are for residents’ involvement in decision-making in everyday life. Interviews and future workshops were carried out with staff and managers in two Swedish nursing homes. The analysis identified differing and partly conflicting perceptions of user participation that have different implications for the residents’ opportunities to be involved in decisions. The staff’s and managers’ approaches to participation ranged from encouraging independent decision-making to excluding the residents from decisions, depending on the situation and the assessment of residents’ abilities. In addition, the analyses showed that perceptions of participation are intertwined with perceptions of good care and with the staff’s and managers’ understandings of their mission and responsibilities. The findings indicate that increasing user participation in nursing homes requires organisational policies that clarify what user participation is and strategies for implementation in daily practice. 
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8.
  • Grim, Katarina, et al. (författare)
  • Development- and usability testing of a web-based decision support for users and health professionals in psychiatric services
  • 2017
  • Ingår i: Psychiatric rehabilitation journal. - Washington, DC : American Psychological Association (APA). - 1095-158X .- 1559-3126. ; 40:3, s. 293-302
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Shared decision making (SMD) related to treatment and rehabilitation is considered a central component in recovery-oriented practice. Although decision aids are regarded as an essential component for successfully implementing SDM, these aids are often lacking within psychiatric services. The aim of this study was to use a participatory design to facilitate the development of a user-generated, web-based decision aid for individuals receiving psychiatric services. The results of this effort as well as the lessons learned during the development and usability processes are reported. Method: The participatory design included 4 iterative cycles of development. Various qualitative methods for data collection were used with potential end users participating as informants in focus group and individual interviews and as usability and pilot testers. Results: Interviewing and testing identified usability problems that then led to refinements and making the subsequent prototypes increasingly user-friendly and relevant. In each phase of the process, feedback from potential end-users provided guidance in developing the formation of the web-based decision aid that strengthens the position of users by integrating access to information regarding alternative supports, interactivity between staff and users, and user preferences as a continual focus in the tool. Conclusions and Implications for Practice: This web-based decision aid has the potential to strengthen service users’ experience of self-efficacy and control as well as provide staff access to user knowledge and preferences. Studies employing participatory models focusing on usability have potential to significantly contribute to the development and implementation of tools that reflect user perspectives.
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9.
  • Grim, Katarina, et al. (författare)
  • Exploring psychiatric users’ decisional and information needs in Shared Decision Making in the light of Elwyn´s three-step model for Clinical practice
  • 2015
  • Ingår i: Closing the gap between research and policy in mental health. - Málaga : ENMESH. - 9788460827818 ; , s. 118-119
  • Konferensbidrag (refereegranskat)abstract
    • Introduction: Using medication and participating in psychosocial interventions are active processes that often involve complex decision-making. Shared decision making, SDM, provides a model for user and practitioner to cooperatively assess a treatment’s advantages and disadvantages. Decision aid tools adapted to the needs of users have the potential to restructure how people with mental illness and staff work together to arrive at shared decisions about the next steps in treatment or support.Aims: The objective of this study is to investigate decisional and information needs among users with mental illness as a pre-requisite for the design and development of a decision aid aimed at supporting user participation in SDM.Methods: Needs and preferences regarding information transfer in SDM were explored through semi-structured focus group interviews. Participants were adults with psychiatric diagnoses and experience of psychiatric services or close relatives to someone with a psychiatric illness.Qualitative content analysis was used to analyze the data. The transcriptions were initially analyzed in accordance with a conventional, inductive approach. A directed content analysis was then utilized, with Elwyn’s three step model for SDM as a theoretical framework from which to further operationalize the categories rendered in the first step of analysis.Results: The majority of the findings were easily integrated within Elwyn ́s categories. However, some elements which emerged in the data and which are worth noting were not encompassed within Elwyn’s model, such as the wish for information prior to the meeting regarding the time frame and agenda. The importance of heeding the prior knowledge of the user as valuable for the decision process and not solely checking it in order to correct possible misinformation was frequently expressed, as was the value of follow-ups.Conclusions: Even though Elwyn’s model is constructed as a pedagogic tool to be used by staff, while our focus is directed towards creating a tool for users, the application of the model upon our data was indeed helpful in rendering clearly defined and distinguishable codes from our categories. We therefore consider it to be a suitable model to continue to build upon in the development of a decision aid.
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10.
  • Grim, Katarina, 1971- (författare)
  • Legitimizing the knowledge of mental health service users in shared decision making : Promoting participation through a web-based decision support tool
  • 2019
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Aim: The overall aim of this thesis was to explore the manner in which user knowledge and user perspectives can be included and supported in shared decision making (SDM) in mental health services.The thesis consists of four studies. Study I explored what needs service users identify to participate in deliberative processes and decision making in their care. Study II examined how a decision support tool (DST) for SDM can be designed to enhance service users’ ability to have active and meaningful roles in SDM. Study III investigated barriers and facilitators associated with the implementation of a web-based DST designed to provide a concrete structure to support SDM. In study IV, a theoretical analysis was performed to elucidate the barriers associated with user knowledge being expressed and legitimized in decision-making processes.Methods: A key feature of the project involved a process of exploring decisional and informational needs and of developing, testing and implementing a DST for SDM. Qualitative data have been collected through focus group and individual interviews with service users and service providers, usability testing with service users and checklists.Findings: The findings show a number of characteristics specific to the mental health service context that need to be considered when developing support for SDM. Decisions were often complex and found to encompass a number of life domains. Issues related to social context and individual recovery highlighted the necessity to include the knowledge perspectives of service users throughout decision processes. In response, phases for preparation and follow-up was emphasized in the DST. The results indicate that supportive structures are required for service users to express their knowledge perspectives and for providers to include them in their decision-making. Moreover, existing barriers related to organizational structures and to power differentials need to be addressed.        Conclusions and implications: A DST specifically designed for the mental health context, that methodically invites service users to participate in each phase of the decision-making process might function as a guiding structure to validate service users as knowledgeable agents.
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11.
  • Grim, Katarina, 1971-, et al. (författare)
  • Legitimizing user knowledge in mental health services : Epistemic (in)justice and barriers to knowledge integration
  • 2022
  • Ingår i: Frontiers in Psychiatry. - Lausanne : Frontiers Media S.A.. - 1664-0640. ; 13
  • Tidskriftsartikel (refereegranskat)abstract
    • Including the voices and knowledge of service users is essential for developing recovery-oriented and evidence-based mental health services. Recent studies have however, suggested that challenges remain to the legitimization of user knowledge in practice. To further explore such challenges, a co-production study was conducted by a team of researchers and representatives from user organizations in Sweden. The aim of the study was to explore the barriers and facilitators to the legitimacy of user knowledge, as a central factor in sustainably implementing user influence in mental health practice. A series of workshops, with representatives of mental health services and user organizations were conducted by the research team to explore these issues. The analysis built on the theoretical framework of epistemic injustice, and the underlying aspects, testimonial, hermeneutic and participation-based injustice, were utilized as a framework for a deductive analysis. Results suggest that this is a useful model for exploring the complex dynamics related to the legitimacy of user knowledge in mental health systems. The analysis suggests that the legitimacy of user knowledge is related to the representativeness of the knowledge base, the systematic formulation of this knowledge inapplicable methods, access to resources and positions within the mental health system and participation in the process of integrating this knowledge-base in mental health contexts. Legitimizing user knowledge in practice additionally challenges mental health systems to support readiness for change in working environments and to address the power and role issues that these changes involve. Copyright © 2022 Grim, Näslund, Allaskog, Andersson, Argentzell, Broström, Jenneteg, Jansson, Schön, Svedberg, Svensson, Wåhlstedt and Rosenberg.
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12.
  • Grim, Katarina, 1971-, et al. (författare)
  • The Legitimacy of User Knowledge in Decision-Making Processes in Mental Health Care : An Analysis of Epistemic Injustice
  • 2019
  • Ingår i: Journal of Psychosocial Rehabilitation and Mental Health. - : Springer Science and Business Media LLC. - 2198-9834 .- 2198-963X. ; 6, s. 157-173
  • Tidskriftsartikel (refereegranskat)abstract
    • The experience-based knowledge of users is considered to provide vital input in shared decision making (SDM). However, mental health service users frequently express having negative experiences from meetings with providers, which are of an epistemic nature (e.g., being ignored or not regarded as credible). This study aimed to explore the barriers involved in legitimizing user knowledge in decision-making processes. Interview data from service users and providers were viewed from a theoretic framework of epistemic injustice. Abductive content analysis was conducted on data collected during a project to develop and implement SDM in mental health services. In describing obstacles to legitimize user knowledge, service users highlighted relational issues: being dependent, often dismissed and choosing to edit their testimonies. Service providers typically described workflow issues, users’ insufficient decision- making competence and users’ vulnerability to stress factors. The findings suggest that greater epistemic justice might be achieved by a SDM process in which the service user is engaged as a full partner in collaboration in various activities related to their care.
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13.
  • Grimm, Katarina, et al. (författare)
  • Shared decision making in community mental health services : Supporting user needs for information and participation
  • 2016
  • Konferensbidrag (refereegranskat)abstract
    • Objectives: Shared decision making (SDM) is a central component in a recovery-oriented practice. While decision aids are essential for implementing SDM, they are still lacking within psychiatric services. The aim of this study was to develop a user-generated, web-based decision aid to support shared decision making in Swedish mental health services.Methods: A decision aid was developed and tested in a preliminary study using a community-based participatory design. This digital tool was then included in a multifaceted intervention study which included staff training and an implementation study that included process and impact evaluation.Results: Models created for SDM in somatic care, fit well for mental health services. However, the results also suggest adaptations since decisions related to mental illness are often complex and involve multiple life domains. Issues related to social context and individual recovery point to a focus on establishing cooperation as well as follow-up over time.Conclusions: The study contributes to an understanding of decisional and information needs, as well as relationship-based and cognitive factors important to consider in adapting SDM in the community mental health system. The decision aid which resulted can strengthen service users’ experience of self-efficacy and control as well as giving staff access to user knowledge and preferences.
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14.
  • Hultman, Lill, et al. (författare)
  • Exploring the Sharing and Legitimacy of Experience-Based Knowledge of Living with Acquired Brain Injury in Two Practice Communities
  • 2023
  • Ingår i: Health & Social Care in the Community. - : Hindawi Publishing Corporation. - 0966-0410 .- 1365-2524. ; 2023
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. Involving people with acquired brain injury in service development has the potential to improve service and give experience-based knowledge legitimacy. The objective of this study was to explore experiences of sharing experience-based knowledge of living with acquired brain injury with others, with a particular focus on the conditions for sharing and learning, and the legitimacy of experience-based knowledge. Materials and Methods. Using a single case study design, the processes in two groups that were part of a Swedish supportive network for people with acquired brain injury were explored. One group consisted mainly of people with acquired brain injury who authored a blog and the other group consisted of healthcare staff who produced educational material with the involvement of a person with own experience of acquired brain injury. The data consisted of forty-one collective blogs, fifteen semistructured individual interviews, and ten observations from meetings. The data were analysed by utilizing the community of practice framework and the concepts of legitimate peripheral participation and epistemic injustice. Results. The findings showed that both groups developed learning processes with a focus on everyday rehabilitation as a joint enterprise. Mutual engagement developed from doing activities together and legitimacy in the groups came from engagement in these activities. In the education group, the ambition to involve people with own experience of acquired brain injury was never realized in practice. Hence, experience-based knowledge of living with acquired brain injury never got legitimacy in the group. Conclusions. We conclude that integrating experience-based knowledge from people with own experience of acquired brain injury demands careful and deliberate planning with specific consideration to existing power asymmetries between healthcare professionals and people with own experience. Mitigating epistemic injustice and gaining legitimacy for such knowledge require that people with experience of living with acquired brain injury are recognized as knowledge producers. 
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15.
  • Kylén, Maya, et al. (författare)
  • Patient Participation and the Environment : A Scoping Review of Instruments
  • 2022
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Patient participation and the environment are critical factors in achieving qualitative healthcare. We conducted a systematic scoping review using Arksey and O’Malley’s framework to identify instruments intended to measure patient participation. We assessed those instruments’ characteristics, which areas of the healthcare continuum they target, and whether environmental factors are considered. Instruments were considered eligible if they represented the patient perspective and measured patient participation in healthcare. The search was limited to articles written in English and published in the last 10 years. We extracted concepts (i.e., patient empowerment, patient participation, and patient-centeredness) based on the framework developed by Castro et al. and outcomes of significance regarding the review questions and specific objectives. The search was conducted in PsycINFO, CINHAL/EBSCO, and PubMed in September 2019 and July 2020. Of 4802 potential titles, 67 studies reported on a total of 45 instruments that met the inclusion criteria for this review. The concept of patient participation was represented most often in these studies. Although some considered the social environment, no instrument was found to incorporate and address the physical environment. Thirteen instruments were generic and the remaining instruments were intended for specific diagnoses or healthcare contexts. Our work is the first to study instruments from this perspective, and we conclude that there is a lack of instruments that measure aspects of the social and physical environment coherently as part of patient participation. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
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16.
  • Ljungberg, Malin, et al. (författare)
  • Who cares? A scoping review about the experiences of parental caregivers of autistic adults
  • 2023
  • Ingår i: JARID. - 1360-2322 .- 1468-3148. ; 36:5, s. 929-939
  • Forskningsöversikt (refereegranskat)abstract
    • Background: The autistic population is growing and ageing and this also applies to the parents. Despite this, research about parental experiences is still relatively scarce. Even though studies show, compared with adults with other disabilities, parents of autistic adolescents and adults report a decrease in well-being and that caregiving is often a lifelong commitment. MethodThis scoping review maps, synthesises and identifies gaps in previous research as regards the experiences of parental caregivers of adult autistic children. The review was based on Arksey and Malley's framework and six databases were searched. Results: The results show how the research has focused on the well-being and consequences of daily caregiving for an American middle-class mother who co-resides with an adult son. Conclusion: To enhance knowledge about formal services and service needs, more research is necessary on different welfare regimes and social contexts.
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17.
  • Markström, Urban, et al. (författare)
  • Developing sustainable service user involvement practices in mental health services in Sweden : the “Userinvolve” research program protocol
  • 2023
  • Ingår i: Frontiers in Psychiatry. - Lausanne : Frontiers Media S.A.. - 1664-0640. ; 14, s. 1-12
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The purpose of this paper is to outline the protocol for the research program “UserInvolve,” with the aim of developing sustainable, service user involvement practices in mental health services in Sweden. Methods: This protocol outlines the knowledge gap and aim of the UserInvolve-program. It further provides an overview of the research infrastructure, with specific focus on the organization and management of the program as well as the design of the six underlying research projects. These six research projects form the core of the UserInvolve-program and will be carried out during a six-year period (2022–2027). The projects are focused on examining articulations of experiential knowledge in user collectives, on four specific user involvement interventions (shared decision-making, peer support, user-focused monitoring, and systemic involvement methods) and on developing theory and method on co-production in mental health research and practice. Results or conclusion: The knowledge gained through the co-production approach will be disseminated throughout the program years, targeting service users, welfare actors and the research community. Based on these research activities, our impact goals relate to strengthening the legitimacy of and methods for co-production in the mental health research and practice field. Copyright © 2023 Markström, Näslund, Schön, Rosenberg, Bejerholm, Gustavsson, Jansson, Argentzell, Grim, Engdahl, Nouf, Lilliehorn and Svedberg.
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18.
  • Moberg, Jennie, et al. (författare)
  • Review : Young people’s recovery processes from mental health problems – a scoping review
  • 2023
  • Ingår i: Child and Adolescent Mental Health. - : Wiley. - 1475-357X .- 1475-3588. ; 28:3, s. 393-407
  • Forskningsöversikt (refereegranskat)abstract
    • Background: Recovery from mental illness and mental health problems is relatively well-researched among adults, but evidence that focuses on the recovery experiences of young people and what characterizes it is scarce. With this in mind, this article aims to map out the existing research in order to identify prevailing knowledge about the recovery of young people between the ages of 12 and 25. Method: Drawing on scoping review methodology, this article is based on an analysis of 33 articles conducted in the USA, Australia, and Eur-ope. Results: Our findings reveal that young people express both similar and divergent lines of reasoning about recovery compared with adults. Our findings also indicate that young people often fluctuate in the way they view recovery, and that they thus tend to be ambivalent about what recovery means. Parents usually high-light the importance of professionals facilitating recovery, while care staff problematize the organizational frameworks available as aggravating circumstances for implementing personal recovery. Young people, parents, and care staff consistently describe recovery as a way to, despite lingering problems, enable a satisfying life. Conclusions: Through this review, we outline the need for a more distinct focus on agency and participation in young people’s recovery processes, at the same time as family involvement needs to be further investigated and operationalized.
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19.
  • Moberg, Jennie, 1984-, et al. (författare)
  • Staff’s experiences of implementing patient-initiated brief admission for adolescents from the perspective of epistemic (in)justice
  • 2022
  • Ingår i: Frontiers in Psychiatry. - : Frontiers Media SA. - 1664-0640. ; 13
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The implementation of Patient-Initiated Brief Admission (PIBA) in child and adolescent psychiatry (CAP) in Sweden is ongoing. This intervention enables adolescents between the ages of 13–17 and with complex mental health problems to initiate a short care period for relief and support rather than the care apparatus being controlling in this process. Offering it is likely to promote epistemic agency, an exchange of knowledge and recovery from mental health problems.Aim: The aim of this study was to explore staff’s perspectives of PIBA for adolescents with complex mental health problems, and what facilitates or hinders its implementation.Methods: Twenty seven employees, 21 women and six men, with various professions in CAP were interviewed and the material was analyzed thematically.Results: Two overall themes emerged: “Staff’s Experiences of PIBA” and “Managing Clinical PIBA Work.” The results were discussed in relation to the theoretical frameworks of epistemic injustice and Normalization Process Theory (NPT). The main findings indicate that PIBA was generally viewed in a positive way, but that obstacles arose when it was actually put into practice. Findings also point at an overall lack of agency among staff when implementing this new way of working, at the same time as the need to adapt PIBA from an adult psychiatric intervention to one for adolescents in CAP is addressed.Conclusion: This article offers insights into the views of psychiatric staff regarding the implementation of PIBA. If staff wish to support epistemic agency and recovery among adolescents, their agency may be an important aspect in the continued implementation. Furthermore, in order for PIBA to become normalized in a sustainable way, we suggest that the continued implementation should be characterized by a youth-friendly framework.
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20.
  • Osman, Fatumo, 1973-, et al. (författare)
  • Effects of a culturally tailored parenting support programme in Somali-born parents' mental health and sense of competence in parenting : a randomised controlled trial
  • 2017
  • Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 7:12
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: To evaluate the effectiveness of a culturally tailored parenting support programme on Somali-born parents' mental health and sense of competence in parenting.DESIGN: Randomised controlled trial.SETTING: A city in the middle of Sweden.PARTICIPANTS: Somali-born parents (n=120) with children aged 11-16 years and self-perceived stress in their parenting were randomised to an intervention group (n=60) or a waiting-list control group (n=60).INTERVENTION: Parents in the intervention group received culturally tailored societal information combined with the Connect parenting programme during 12 weeks for 1-2 hours per week. The intervention consisted of a standardised training programme delivered by nine group leaders of Somali background.OUTCOME: The General Health Questionnaire 12 was used to measure parents' mental health and the Parenting Sense of Competence scale to measure parent satisfaction and efficacy in the parent role. Analysis was conducted using intention-to-treat principles.RESULTS: The results indicated that parents in the intervention group showed significant improvement in mental health compared with the parents in the control group at a 2-month follow-up: B=3.62, 95% CI 2.01 to 5.18, p<0.001. Further, significant improvement was found for efficacy (B=-6.72, 95% CI -8.15 to -5.28, p<0.001) and satisfaction (B=-4.48, 95% CI -6.27 to -2.69, p<0.001) for parents in the intervention group. Parents' satisfaction mediated the intervention effect on parental mental health (β=-0.88, 95% CI -1.84 to -0.16, p=0.047).CONCLUSION: The culturally tailored parenting support programme led to improved mental health of Somali-born parents and their sense of competence in parenting 2 months after the intervention. The study underlines the importance of acknowledging immigrant parents' need for societal information in parent support programmes and the importance of delivering these programmes in a culturally sensitive manner.CLINICAL TRIAL REGISTRATION: NCT02114593.
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21.
  • Osman, Fatumo, et al. (författare)
  • Parenthood in transition : Somali-born parents' experiences of and needs for parenting support programmes
  • 2016
  • Ingår i: BMC International Health and Human Rights. - : Springer Science and Business Media LLC. - 1472-698X. ; 16:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Pre- and post-migration trauma due to forced migration may impact negatively on parents' ability to care for their children. Little qualitative work has examined Somali-born refugees' experiences. The aim of this study is to explore Somali-born refugees' experiences and challenges of being parents in Sweden, and the support they need in their parenting.METHODS: A qualitative descriptive study was undertaken. Data were collected from four focus group discussions (FGDs) among 23 Somali-born mothers and fathers living in a county in central Sweden. Qualitative content analysis has been applied.RESULTS: A main category, Parenthood in Transition, emerged as a description of a process of parenthood in transition. Two generic categories were identified: Challenges, and Improved parenting. Challenges emerged from leaving the home country and being new and feeling alienated in the new country. In Improved parenting, an awareness of opportunities in the new country and ways to improve their parenting was described, which includes how to improve their communication and relationship with their children. The parents described a need for information on how to culturally adapt their parenting and obtain support from the authorities.CONCLUSIONS: Parents experienced a process of parenthood in transition. They were looking to the future and for ways to improve their parenting. Schools and social services can overcome barriers that prevent lack of knowledge about the new country's systems related to parenthood. Leaving the home country often means separation from the family and losing the social network. We suggest that staff in schools and social services offer parent training classes for these parents throughout their children's childhood, with benefits for the child and family.
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22.
  • Osman, Fatumo, 1973-, et al. (författare)
  • The implementation of a culturally tailored parenting support programme for Somali immigrant parents living in Sweden : A process evaluation
  • 2022
  • Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:9
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Parental support programmes aim to strengthen family functioning and the parent-child relationship and to promote the mental health of children and parents. However, there is a lack of knowledge on how parenting support programmes can be implemented for newly arrived immigrant parents. This process evaluation describes the implementation of a successful parenting programme for immigrant parents from Somalia and identifies key components of the implementation process with a focus on Reach, Adaptation, and Fidelity of Ladnaan intervention.METHOD: This process evaluation considered context, implementation and mechanism of impact, in accordance with the Medical Research Council's guidance. Data were collected through focus group discussions, a questionnaire, attendance lists, field and reflection notes and observations of the sessions. The data were then analysed using content analysis and descriptive statistics.RESULTS: Of the 60 parents invited to the parenting programme, 58 participated in the sessions. The study showed that involving key individuals in the early stage of the parenting programme's implementation facilitated reaching Somali-born parents. To retain the programme participants, parents were offered free transportation. The programme was implemented and delivered as intended. A majority of the parents were satisfied with the programme and reported increased knowledge about children's rights and the support they could seek from social services.CONCLUSIONS: This study illustrates how a parenting support programme can be implemented for Somali-born parents and provides guidance on how to attract immigrant parents to and engage them in participating in parenting support programmes.
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23.
  • Quarles van Ufford, Sara, et al. (författare)
  • Discretion and Strategies for Investigating Child Abuse : Social Workers' Conceptions of Child Abuse Investigations and Police Reporting
  • 2023
  • Ingår i: British Journal of Social Work. - 0045-3102 .- 1468-263X.
  • Tidskriftsartikel (refereegranskat)abstract
    • Understanding the capacity of child welfare (CW) organisations to deal with child abuse is complex, and dependent on the specific CW context. Sweden occupies a unique position in trying to balance high demands for CW and protection with a strong family support focus, which carries a risk of overlooking children who need protection. Drawing on an understanding of social service organisations as street-level bureaucracies, this article explores discretion in child abuse cases by examining conditions affecting discretion and strategies for investigating child abuse, including police reporting. Thematic analysis of interviews with Swedish supervising social workers showed that staff's conceptions of the CW system influenced the exercise of discretion, leading to different strategies for dealing with child abuse. This resulted in different practices and potentially unequal access to child protection and support, highlighting the wide margin of discretion. This article concludes that the interplay between knowledge and governance is central to equal child protection. This article contributes to the discussion of discretion in CW organisations by underlining the importance of being particularly vigilant about discretion when both children and parents are considered clients, as the child risks being lost as a subject with individual needs and rights. Understanding the capacity of child welfare (CW) organisations to deal with child abuse is complex. Sweden occupies a unique position in trying to balance high demands for CW and protection with a strong family support focus, which carries a risk of overlooking children in need of protection. This article explores the handling of child abuse cases by examining conditions affecting discretion and strategies for investigating child abuse, including police reporting. Analysis of interviews with Swedish supervising social workers showed that staff's conceptions of the CW system influenced the handling, leading to different strategies for dealing with child abuse. This resulted in different practices and potentially unequal access to child protection and support, underscoring the importance of being particularly vigilant about discretion when both children and parents are considered clients: the child risks being lost as a subject with individual needs and rights. This article concludes that the interplay between knowledge and governance is central to equal child protection.
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24.
  • Quarles van Ufford, Sara, et al. (författare)
  • The Swedish social services' police reporting and children's access to protection and support in child abuse cases : A quantitative content analysis
  • 2022
  • Ingår i: International Journal of Child Abuse & Neglect. - : Elsevier BV. - 0145-2134 .- 1873-7757. ; 133
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The UN Convention on the Rights of the Child prohibits all forms of violence against children. Sweden was early in introducing a ban on disciplinary violence; however, difficulties have been noted in identifying children in need of protection and providing help for children exposed to violence.Objectives: The purpose of this study was to explore the social services' police reporting and children's access to protection and support in cases of physical and sexual child abuse.Methods: The sample consisted of 291 child welfare reports from three Swedish municipalities. Data were collected from child welfare reports, investigations, and child social records and analyzed using quantitative content analysis.Results: A majority of the cases, including cases with a high indication for police reporting, were not reported to the police by the social services. Although the child in 60.1 % of cases provided information about violence, 70.7 % of all child welfare investigations were completed without support measures, and only 8.2 % led to protection or support linked to violence. Children's participation was limited, suggesting inadequate conditions for children's access to protection and support.Conclusions: Children's right to protection against violence requires the recognition of children as active participants with access to safe participation. Failure to report suspected crimes against children risks minimizing acts of violence or making violence invisible. Difficulties in handling conflicts of interest between children and parents risk neither protection nor support being provided for the child.
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25.
  • Rosenberg, David, 1957-, et al. (författare)
  • Establishing a Recovery Orientation in Mental Health Services : Evaluating the Recovery Self-Assessment (RSA) in a Swedish Context
  • 2015
  • Ingår i: Psychiatric rehabilitation journal. - Washington, DC : American Psychological Association (APA). - 1095-158X .- 1559-3126. ; 38:4, s. 328-335
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: Although there has been an emphasis on developing knowledge regarding recovery in Sweden, it is unclear to what extent this has been translated into a recovery orientation in the provision of mental health services. Instruments, which present the components of recovery as measurable dimensions of change, may provide a framework for program development. Involving users is an essential factor in the utilization of such tools. The purpose of this study was to evaluate the psychometric properties of the Recovery Self-Assessment (RSA) measure and its potential for being utilized in a Swedish context.METHODS: The sample consisted of 78 participants from 6 community mental health services targeting people with serious mental illnesses in a municipality in Sweden. They completed the RSA at the study baseline and two weeks later. User panels participated in the translation and administration of the RSA and the reporting of results.RESULTS: The Swedish version of the RSA had good face and content validity, satisfactory internal consistency, and a moderate to good level of stability in test-retest reliability. The user panels contributed to establishing validity and as collaborators in the study.CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Establishing the RSA as a valid and reliable instrument with which to focus on the recovery orientation of services is a first step in beginning to study the types of interventions that may effect and contribute to recovery oriented practice in Sweden. © 2015 APA, all rights reserved
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26.
  • Rosenberg, David, 1957-, et al. (författare)
  • Establishing a Recovery Orientation in Swedish Mental Health Services; From attitudes to instruments
  • 2015
  • Ingår i: Closing the gap between research and policy in mental health. - Málaga : ENMESH. - 9788460827818 ; , s. 114-114
  • Konferensbidrag (refereegranskat)abstract
    • Introduction: Although there has been an emphasis on developing knowledge of recovery in Sweden, it is unclear to what extent this has been translated into a recovery orientation in the provision of mental health services. Educational initiatives focused primarily on changing attitudes have not produced concrete outcomes. Instruments that define the components of recovery as measurable dimensions of change may provide a framework for implementing recovery-oriented services.Aims: The aim of this study was to investigate whether the use of instruments which measure a recovery orientation in services could provide program level outcome indicators, that could point to concrete needs for change. An additional aim was to study the contribution of peer support workers to this process.Methods: Two internationally tested and validated instruments were distributed to 85 clients from 6 community mental health services targeting people with a diagnosis of psychosis in a municipality in Sweden. These focused on the recovery orientation of services (RSA) and the recovery orientation of relationships with the primary contact person (Inspire). An additional instrument (RKI) was distributed to all staff to assess their knowledge of recovery paradigms. Peer support workers participated in the translation, administration and reporting of results.Results: The instruments were translated to Swedish, tested and found to have acceptable psychometric properties. The reports pro-duced from these instruments highlighted specific areas for improvement which these user assessments had indicated. These included for example; opportunities to influence services and care plans, to receive support for activities outside of psychiatry, to have their strengths included in assessments and to have more access to experience-based knowledge. The peer support workers provided valuable support to the process and were additionally seen by the clinic staff as a valuable resource in future work.Conclusions: Instruments which measure a recovery orientation in mental health services can contribute to a focus on specific knowledge, attitudinal and skill gaps that service organisations can target in their quality development activities. In the present study, staff were more accepting of this feedback since it came directly from their clients and was collected and presented systematically.
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27.
  • Rosenberg, David, 1957-, et al. (författare)
  • Shared decision making in community mental health services - an evaluation of three self-reporting instruments
  • 2017
  • Ingår i: Journal of Mental Health. - Abingdon, Oxon : Routledge. - 0963-8237 .- 1360-0567. ; 26:2, s. 142-149
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Despite the potential impact of shared decision making on users satisfaction with care and quality in health care decisions, there is a lack of knowledge and skills regarding how to work with shared decision making among health care providers.Aim: The aim of this study was to evaluate the psychometric properties of three instruments that measure varied dimensions of shared decision making, based on self-reports by clients, in a Swedish community mental health context.Method: The study sample consisted of 121 clients with experience of community mental health care, and involved in a wide range of decisions regarding both social support and treatment. The questionnaires were examined for face and content validity, internal consistency, test-retest reliability and construct validity.Results: The instruments displayed good face and content validity, satisfactory internal consistency and a moderate to good level of stability in test-retest reliability with fair to moderate construct correlations, in a sample of clients with serious mental illness and experience of community mental health services in Sweden.Conclusions: The questionnaires are considered to be relevant to the decision making process, user-friendly and appropriate in a Swedish community mental health care context. They functioned well in settings where non-medical decisions, regarding social and support services, are the primary focus. The use of instruments that measure various dimensions of the self-reported experience of clients, can be a key factor in developing knowledge of how best to implement shared decision making in mental health services.
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28.
  • Schön, Ulla-Karin, 1970- (författare)
  • Brukarmedverkan i en evidensbaserad praktik
  • 2012
  • Konferensbidrag (refereegranskat)abstract
    • BakgrundNär det gäller stöd och service till människor med psykisk ohälsa finns idag en förhållandevis god kunskap om människors möjligheter till återhämtning från allvarliga psykiska besvär (Schön, 2009; Slade 2011; Topor 2004). Faktorer som brukarmedverkan, kontinuitet, sociala relationer är några av de faktorer som identifieras som grundläggande i en återhämtningsprocess (a.a). Fortfarande är dock brukarmedverkan i socialtjänsten en begränsad praktik och relativt outforskat. Trots att det på senare år allt mer påtalats att socialtjänstens praktik behöver bli en ”evidensbaserad” praktik är användandet av brukarkunskap i socialtjänstens en saknad del i en sådan kunskapsutveckling (McLaughlin, 2011). En evidensbaserad praktik definieras ofta som att bestå av ”tre ben” bästa tillgängliga kunskap, de professionella samt brukarnas kunskaper och önskemål. Brukarmedverkan i denna process innebär att brukare och deras närstående inte bara ses som aktörer i en politisk process, utan också som en omistlig kunskapskälla med erfarenheter och perspektiv viktiga för en bred kunskapsbildning (Socialstyrelsen 2005).Argument och fokus för brukarmedverkan kan relateras till tre områden, nämligen frågor relaterade till demokrati (Dahlberg & Vedung, 2001), frågor relaterade till makt och egenmakt (Beresford et al, 2008; Beresford 2010) samt frågor relaterade till tjänsters utveckling (Barnes et al 2000), där utvecklingen av en evidensbaserad social service ingår. Vissa forskare menar att socialtjänstens utveckling, i likhet med andra områden såsom t ex vård och omsorg, under senare år har präglats av en stark individualisering och valfrihets ambition utifrån en top-down perspektiv, vilket anses ha överskuggat den demokratiska eller "bottom-up"-strategi som är mer kritisk och främjande av social förändring och social rättvisa (Beresford 2010; Ferguson, 2008). I Storbritannien t ex har t ex brukarmedverkan setts som framgångsrikt om deltagande har varit framgångsrik i motsats till att fokusera på resultat eller effekt av detta deltagande för t ex utvecklingen av tjänster eller forskning (Carr 2004; McLaughlin, 2009).SyfteSyftet med detta projekt är att studera och utveckla kunskapsområdet brukarmedverkan i socialtjänstens praktik. Detta ska ske genom en kunskapsöversikt av betydelsen av brukarmedverkan i socialtjänstens praktik. Ett annat syfte är att pröva om, och i så fall hur, brukarkunskap påverkar kunskapsområdet genom att göra erfarenhetsbaserad kunskap tillgänglig för lärande för studenter, yrkesverksamma och för forskare inom socialt arbete. Ett ytterligare syfte är att undersöka vad brukarmedverkan i en sådan erfarenhetspanel kan innebära för enskildas återhämtningsprocesser från psykisk ohälsa. 
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29.
  • Schön, Ulla-Karin, 1970- (författare)
  • Can gender sensitivity in psychiatry improve recovery?
  • 2012
  • Konferensbidrag (refereegranskat)abstract
    • Introduction: In recent years research on recovery have resulted in new knowledge and gained relevance in the mental health field. Still recovery is discussed in terms of individual journeys to find ways to live a hopeful and satisfying life. Taking the concept of gender into consideration it is possible to begin to address additional questions about how women and men influence their recovery; how they perceive and understand the society in which they live, and how they are likely to be regarded and treated within that society.Methods: In a study conducted in Sweden 30 first-person accounts of recovery from mental illness were examined. The study was undertaken to determine if there was gender diversity in what people described as being decisive factors for their recovery.Results: The results illustrates a gender advantage for the men in their ability to make use of the psychiatric services offered in their coping strategies mainly focusing on remission, education and control over symptoms. The women, on the other hand, described hospitalization and psychiatric medication more in terms of coercion and helplessness. These results may raise the need for a gender perspective in psychiatry to reduce the female impediment to access to safe and effective psychiatric care. But the results also illustrate how gender norms, outside psychiatry, benefit women more than men in a recovery perspective. In spite of structural gender inequalities, female gender norms seemed to be an advantage in the recovery process. The female recovery process was focused on making sense and meaning, whereas the male recovery process was focused on reinforcement of traditional roles such as occupation and independence. The women also had a higher capacity to receive and maintain support from their social networks than did the men.
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30.
  • Schön, Ulla-Karin, 1970-, et al. (författare)
  • Evaluating the INSPIRE measure of staff support for personal recovery in a Swedish psychiatric context
  • 2015
  • Ingår i: Nordic Journal of Psychiatry. - London : Informa Healthcare. - 0803-9488 .- 1502-4725. ; 69:4, s. 275-281
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Recovery is understood to be an individual process that cannot be controlled, but can be supported and facilitated at the individual, organizational and system levels. Standardized measures of recovery may play a critical role in contributing to the development of a recovery-oriented system. The INSPIRE measure is a 28-item service user-rated measure of recovery support. INSPIRE assesses both the individual preferences of the user in the recovery process and their experience of support from staff. Aim: The aim of this study was to evaluate the psychometric properties of the Swedish version of the INSPIRE measure, for potential use in Swedish mental health services and in order to promote recovery in mental illness. Method: The sample consisted of 85 participants from six community mental health services targeting people with a diagnosis of psychosis in a municipality in Sweden. For the test-retest evaluation, 78 participants completed the questionnaire 2 weeks later. Results: The results in the present study indicate that the Swedish version of the INSPIRE measure had good face and content validity, satisfactory internal consistency and some level of instability in test-retest reliability. Conclusions: While further studies that test the instrument in a larger and more diverse clinical context are needed, INSPIRE can be considered a relevant and feasible instrument to utilize in supporting the development of a recovery-oriented system in Sweden. © 2014 Informa Healthcare.
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31.
  • Schön, Ulla-Karin, 1970- (författare)
  • How men and women in recovery make meaning to severe mental illness
  • 2009
  • Ingår i: Journal of Mental Health. - : Informa UK Limited. - 0963-8237 .- 1360-0567. ; 18:5, s. 433-440
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Creating a new meaning of the illness, changing values and expectations due to the illness are seen as important factors in recovery from mental illness.Aims: In this study, conducted in Sweden, male and female meaning making of severe mental illness is explored and how these meanings compass the recovery process.Method: Through 30 in-depth interviews male and female meaning of mental illness are explored through a grounded theory analysis. Results: In the process of making meaning illness reason emerged as the core category. But the reasons differed both in relation to gender and within the two genders. Four patterns of response were found in the analysis of the material. These four patterns influenced how the recovery process was encompassed. Three of the four groups were restructing the meaning of the illness in a more favorable way contributing to a redirection of life towards authenticity.Conclusions: The results underline a demand for further research on recovery achievements connected to meaning making and changes in attitude. One such area is to create a meaning in one’s life where gender is reconsidered in relation to the individual’s capacity and life situation.
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32.
  • Schön, Ulla-Karin, 1970-, et al. (författare)
  • Managing a fragile motivation within an unfit organisation : young adults' experiences of support to achieve employment [Att hantera en skör motivation i en illa lämpad organisation: Unga vuxnas erfarenheter av stöd för att uppnå sysselsättning]
  • 2023
  • Ingår i: European Journal of Social Work. - 1369-1457 .- 1468-2664.
  • Tidskriftsartikel (refereegranskat)abstract
    • This article explores subjective realities of being not in employment, education or training (NEET), with a specific focus on support needs and how labour market support fits these needs. A total of 23 semi-structured interviews were conducted with participants aged 18–29 who had just been recruited to a work support program aimed at increasing the availability, coordination, and individualisation of support in order to enhance the possibility of finding work. The results illustrate a clear yet fragile motivation to work among the respondents. The participants expressed optimism that they would find a job, but were also clear about the need for adaptations in the workplace to succeed. Through the lens of crip time, the participants expressed a need for flexibility and extra time to perform tasks such as finding a job and feeling comfortable in the workplace, compared to the needs of abled people. Rules and time limits at the Public Employment Service and the Social Insurance Agency reinforced the image of this normative time, making the participants express their needs as a deviation from what is considered normal. 
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33.
  • Schön, Ulla-Karin, 1970-, et al. (författare)
  • Psychiatric service staff perceptions of implementing a shared decision-making tool : a process evaluation study
  • 2018
  • Ingår i: International Journal of Qualitative Studies on Health and Well-being. - Abingdon : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 13:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: Shared decision making, SDM, in psychiatric services, supports users to experience a greater sense of involvement in treatment, self-efficacy, autonomy and reduced coercion. Decision tools adapted to the needs of users have the potential to support SDM and restructure how users and staff work together to arrive at shared decisions. The aim of this study was to describe and analyse the implementation process of an SDM intervention for users of psychiatric services in Sweden.Method: The implementation was studied through a process evaluation utilizing both quantitative and qualitative methods. In designing the process evaluation for the intervention, three evaluation components were emphasized: contextual factors, implementation issues and mechanisms of impact.Results: The study addresses critical implementation issues related to decision-making authority, the perceived decision-making ability of users and the readiness of the service to increase influence and participation. It also emphasizes the importance of facilitation, as well as suggesting contextual adaptations that may be relevant for the local organizations.Conclusion: The results indicate that staff perceived the decision support tool as user-friendly and useful in supporting participation in decision-making, and suggest that such concrete supports to participation can be a factor in implementation if adequate attention is paid to organizational contexts and structures.
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34.
  • Schön, Ulla-Karin, 1970- (författare)
  • Recovery from mental illness, a gender perspective
  • 2010
  • Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 24:3, s. 557-564
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and research objectives: Recovery from mental illness is an individual process characterized by regaining a positive sense of self and developing a new meaning. Knowledge concerning differences between male and female recovery processes is, however, limited. The objective of this study was to determine gender diversity in what individuals described as decisive factors for their recovery.   Subjects and methods:  In this qualitative study based on grounded theory 30 first-person accounts of recovery from mental illness are examined. After informed consent data were collected through in-depth interviews with people in recovery from psychosis, bipolar disorders or personality disorders.   Results: The results show that in spite of structural gender inequalities, female gender norms seem to be an advantage in the recovery process. The female participants were focused on making sense and meaning in their recovery process, while the male participants were focused on control over symptoms and reinforcement of traditional roles such as occupation and independence. Another result showed psychiatric hospitalization to mainly contribute to male recovery processes.   Conclusion: These results provide new insights into gender as an important factor in understanding recovery processes and in providing care to facilitate these processes.
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35.
  • Schön, Ulla-Karin, 1970- (författare)
  • The power of identification. Peer support in recovery from mental illness
  • 2010
  • Ingår i: Scandinavian Journal of Disability Research. - : Stockholm University Press. - 1501-7419 .- 1745-3011. ; 12:2, s. 83-90
  • Tidskriftsartikel (refereegranskat)abstract
    • Abstract: Peer support has been described as facilitating individuals’ recovery from mental illness and offer useful support, hope and encouragement. The aim of this study was to explore how individuals with experience of severe mental illness in Sweden perceived peer support facilitating their recovery. The results from the grounded theory analysis of 24 in depth interviews illustrated that despite diagnoses of severe mental illness, often described in terms of an inability to interact with other people, the identification when meeting others with similar experiences was powerful. The participants described how peer support meant an end to isolation and became an arena for identification, normalization, connection and being important to others. Involvement in the peer support group was related to time and recovery stage, the participants pay attention to their own achievements in relation to peers and their recovery progress, comparing their level of wellness with that of their peers.
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36.
  • Schön, Ulla-Karin, 1970-, et al. (författare)
  • Transplanting recovery? : Research and practice in the Nordic countries
  • 2013
  • Ingår i: Journal of Mental Health. - : Informa UK Limited. - 0963-8237 .- 1360-0567. ; 22:6, s. 563-569
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The conceptual framework which describes recovery from mental illness is based primarily on studies conducted in English-speaking countries. Knowledge and development of recovery orientation within other cultures and mental health systems is still limited.Aim: The aim of this study was to compile, describe, and discuss the research on personal recovery and recovery-oriented practice within the psychiatric and social fields in the Nordic countries.   Method: A systematic literature review of Nordic research on recovery from mental illness. Results: The research literature is limited, and primarily replicates designs and confirms findings first presented in studies conducted in the USA and Great Britain.The majority of the studies are qualitative, and point to the importance of social relations, environmental factors, and peer support. Conclusions: There is a need to identify and describe factors in Nordic mental health systems that may influence the recovery process. A corresponding challenge will be to translate and further develop outcome indicators that can promote a recovery-oriented health system.
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37.
  • Schön, Ulla-Karin, 1970-, et al. (författare)
  • Transplanting Recovery? Research and practice in the Nordic countries
  • 2013
  • Ingår i: Tenth International Conference of the European Network For Mental Health Service Evaluation. ; , s. 205-205
  • Konferensbidrag (refereegranskat)abstract
    • Background/ObjectivesThe conceptual framework which describes recovery from mental illness is based primarily on studies conducted in English-speaking countries. Knowledge and development of a recovery orientation within other cultures and mental health systems is still limited, and few studies have discussed the impact of varied national contexts on the development and implementation of recovery-oriented services. The aim of this study was to compile, describe and discuss the research on personal recovery and recovery oriented practice within the psychiatric and social fields in the Nordic countries. MethodsA systematic literature review of Nordic research on recovery from mental illness was conducted which included studies that clearly focused on Recovery as a knowledge base in psychiatric and social services.ResultsTwenty one studies were reviewed, summarized and analyzed with regard to their findings regarding the recovery process, descriptions of interventions which promote recovery and factors which might be specific to the Nordic context and mental health system. The majority of the studies were qualitative and stressed the importance of social relations, environmental factors and peer support. The identified research literature was limited and primarily replicated designs and confirmed findings first presented in North American and British studies. Few studies referred to aspects of welfare system, mental health service structures or cultural factors that might impact the recovery process.Discussion/ConclusionThere is a need to identify and describe factors in Nordic mental health systems that may influence the recovery process. If research does not attend to cultural and organizational differences that may impact the development and implementation of recovery services there is a risk that users will not gain access to these interventions in a manner relevant to their needs. A corresponding challenge will be to translate and further develop outcome indicators that can promote a recovery oriented health system.
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38.
  • Schön, Ulla-Karin, 1970- (författare)
  • User and carer involvement in social work education : reasons for participation
  • 2016
  • Ingår i: Scandinavian Journal of Disability Research. - : Stockholm University Press. - 1501-7419 .- 1745-3011. ; 18:2, s. 154-163
  • Tidskriftsartikel (refereegranskat)abstract
    • In many countries, user involvement in social work (SW) education is common practice, while in other countries, initiatives for inclusion are currently expanding. No matter how far the progress of user involvement in education has come, issues on clarity, sustainability and accountability need to be addressed. In this paper, users’ reasons for wanting to participate in SW education and the way they define their potential contribution are explored. These experiences can provide important information contributing to sustainable, meaningful, and accountable collaborations between users, university staff and students. Participants (n = 33) answered a questionnaire including demographic data and four open-ended questions about their expectations of participation in a SW programme at the University of Dalarna in Sweden. The results from the open-ended questions were analysed using qualitative content analysis. Results show that users’ main reasons for wanting to get involved were to contribute through sharing their lived experience of SW education, to help improve services and also to obtain respect for their own personal knowledge and experience. The respondents described themselves both as carriers of valuable knowledge and as accountable experts on the subject.
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39.
  • Schön, Ulla-Karin, 1970- (författare)
  • User involvement in social work and education : a matter of participation?
  • 2016
  • Ingår i: Journal of Evidence-Informed Social Work. - : Informa UK Limited. - 2376-1407 .- 2376-1415. ; 13:1, s. 21-33
  • Tidskriftsartikel (refereegranskat)abstract
    • The increase in user involvement in social work practice and education can be explained by incentives toward an evidence-based practice, such as those offered by legislation and from the user movement, and those related to professional development. Still, the clients' involvement in research and practice is highlighted as a gap that needs to be filled. The aim of the author in this article is to study the presence of user involvement in social work practice, research, and education, and the level of influence of users and carers within these activities. The results reflect an expanding user involvement in social work practice. Still, projects of user involvement in social work practice are often developed on an ad hoc and inconsistent basis, and knowledge about the effects of these efforts is still limited. User involvement is not to be understood as something that is self-evidently good. On the contrary, the results present a rather complex concept that is bound up with changing and contested understandings of the role of the social worker, academia, and the users themselves.
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40.
  • Schön, Ulla-Karin, 1970- (författare)
  • Young adults' experiences of living with paediatric acute-onset neuropsychiatric syndrome : An interview study
  • 2023
  • Ingår i: International Journal of Qualitative Studies on Health and Well-being. - 1748-2623 .- 1748-2631. ; 18:1
  • Tidskriftsartikel (refereegranskat)abstract
    • AimThis article explores experiential knowledge of living with paediatric acute-onset neuropsychiatric syndrome (PANS), and the factors that are associated with perceived good care.MethodsTen people with lived experience of PANS participated, five women and five men aged 19-34. Semi-structured interviews were used to explore their experience of living with PANS and their encounters with healthcare. Thematic analysis was carried out to identify central themes in the transcribed interviews.ResultsThe study revealed a group of young adults living fairly isolated lives, dependent on care from relatives. To them, the illness was a tangible presence. They perceived a lack of knowledge among healthcare staff on PANS in healthcare, and negative consequences linked to this. In addition, their experience-based knowledge of their own illness is devalued in healthcare encounters. A feeling of being pushed around in healthcare, without anyone taking responsibility for the treatment, emerged in the interviews. The participants emphasized the need for increased knowledge among staff to identify PANS and be able to offer effective treatment.Conclusion There is a need to increase the knowledge about PANS in healthcare and to coordinating care between neurology, immunology and psychiatry. To be able to offer evidence-based care to children with PANS, in-depth knowledge is needed about aetiology, treatment effects, and user experiences and preferences.
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41.
  • Svedberg, Petra, 1973-, et al. (författare)
  • Measuring client’s experiences of shared decision making in psychiatric services
  • 2015
  • Ingår i: Closing the gap between research and policy in mental health. - Málaga : ENMESH. - 9788460827818 ; , s. 117-118
  • Konferensbidrag (refereegranskat)abstract
    • Introduction: While increased democratization and user participation are strongly emphasized political and ideological goals within the entire healthcare sector, research-based knowledge about how to achieve these goals is limited, not least in the psychiatric field. Shared decision-making, SDM, is an internationally described method which seeks to increase users’ involvement in health care decisions. However, knowledge of SDM as a method is limited, and research has focused primarily on SDM in medical decisions in somatic care. Despite the potential impact of SDM on users satisfaction with care and the quality in health care decisions, there is a lack of competence and skills in how to work with SDM among health care providers. Validated measures of SDM can play a critical role in supporting healthcare providers to increase their knowledge and skills in order to promote patient participation in healthcare.Aims: This project intends to increase knowledge regarding how SDM can be effectively evaluated in psychiatric services in Sweden.Methods: The present study has a methodological design where the translated version of the instruments Dyadic option, SURE and CollaboRATE were psychometrically investigated. It was carried out in 2014 at 19 municipal social psychiatry units in Sweden. The study sample consisted of 105 clients in contact with these services and the criteria for inclusion were that the clients were over 18 years of age and had experience of a decision having been taken.Results: A Swedish version of Dyadic option, SURE and CollaboRATE are acceptable in terms of face and content validity, internal consistency and stability. The concurrent validity of Dyadic option was demonstrated with positive correlations with SURE and CollaboRATE. However, there was no correlation between SURE and CollaboRATE.Conclusions: In the presentation, the findings of the evaluation of the SDM process in psychiatric care will be discussed. Furthermore, we will also discuss how the use of instruments that measure SDM in psychiatric health care can provide a tool for contributing to a structured person-centered dialogue between clients and staff, as well as how evaluations of SDM can contribute to the quality of the decision and ensure informed consent.
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