| 1. |
- Liljeholm, Ulrika, et al.
(författare)
-
Att utveckla arbetsidentitet hos unga vuxna med psykisk ohälsa
- 2019
-
Konferensbidrag (refereegranskat)abstract
- Bakgrund: Hur vi identifierar oss är starkt kopplat till arbete. Unga vuxna är en känslig grupp när det gäller inträde på arbetsmarknaden. Om de också har psykisk ohälsa blir det ännu svårare och risken för marginalisering ökar. Likväl har arbete visat väsentlig betydelse för en personlig återhämtning. Syftet med studien var att utforska erfarenheter bland unga vuxna med psykisk ohälsa som börjar arbeta, med fokus på processen att utveckla arbetsidentitet. Ytterligare syfte var att utveckla kunskap för att förbättra kliniskt resonemang bland arbetsterapeuter och andra yrkesverksamma inom psykiatrisk rehabilitering och arbetsinriktad verksamhet i strävan att stödja unga i deras övergång i arbete och därmed vardagligt socialt och samhällsliv.Metod: Grounded teori användes som design. Materialet bestod av 13 djupintervjuer med unga vuxna med psykisk ohälsa i åldern 19-26 år, som arbetat i minst tre månader. Resultat: Att börjar arbeta bidrog med en process av inre och yttre förändring, nya känslor, utmaningar och förståelse för omvärlden. Tidigare negativa tankemönster blev mer positiva. Nya roller och aktivitetsmönster utvecklades vilket förändrade synen på egen förmåga och därigenom self-efficacy. Denna utveckling bidrog till en positiv process som gav en arbetsidentitet och nya riktningar i livet. Slutsatser: Vi antar att processen att utveckla arbetsidentitet stöder övergången till vuxen ålder och en karriärutveckling för unga vuxna med psykiska ohälsa. Resultaten stöder att utveckling av arbetsidentitet förväntas vara en del av en personlig återhämtningsprocess för individer. Stöd till unga vuxna med psykisk ohälsa genom möjligheter att arbeta är kritiskt.
|
|
| 2. |
- Liljeholm, Ulrika, et al.
(författare)
-
Work identity development in young adults with mental health problems
- 2019
-
Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 27:6, s. 431-440
-
Tidskriftsartikel (refereegranskat)abstract
- Background: How we identify ourselves is strongly related to employment. Young adults are a vulnerable group with regard to entering the Labor market. If they also have mental health problems, entering becomes more difficult and increases risk of early marginalization. Nevertheless, working can be essential for personal recovery process. Aims: To explore experiences of young adults with mental health problems who are starting to work, with a focus on the process of developing work identity. Methods: Grounded theory design was used. The data collection consisted of 13 in-depth interviews with young adults with mental health problems aged 19–26 years, who had worked for at least three months. Results: The experience of starting to work contributed to a process of internal and external change, new feelings, challenges, and understanding of the surrounding world. Former negative thought patterns became more positive. New roles and occupational patterns were developed and altered views on abilities, and thus self-efficacy. This development contributed to a work identity, and new directions in life. Conclusions: There is therapeutic potential in supporting work identity development, and this support can empower the personal recovery process for young adults.
|
|
| 3. |
- Andersén, Åsa, 1975-
(författare)
-
Self-efficacy, Vocational Rehabilitation and Transition to Work
- 2017
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to examine the relationship between self-efficacy, individually tailored vocational rehabilitation and transition to work or studies.Study I was a cross-sectional study based on questionnaire- and registry data, investigating whether factors related to sick leave predict self-efficacy in women on long-term sick leave (n= 337) due to pain and/or mental illness. General self-efficacy was low. Anxiety and depression were the strongest predictors for low self-efficacy.Study II used longitudinal data from a randomised controlled trial, comprising partly the same women (n=401) as in Study I. Participants were allocated to either 1) assessment of multidisciplinary team and multimodal intervention (TEAM), 2) acceptance and commitment therapy (ACT), or 3) control group. Self-efficacy increased in the TEAM group in comparison with the control group.Study III had a descriptive qualitative design with individual interviews, studying participants’ (n=14) experiences with an individually tailored vocational rehabilitation project, and encounters with professionals working in it. The participants, who were on long-term sick leave due to mental illness or pain reported overall positive experiences with the project. The project was based on collaboration between authorities and motivational interviewing. The positive experiences were based on four categories: Opportunities for receiving various dimensions of support, Good overall treatment by the professionals, Satisfaction with the working methods of the project, and Opportunities for personal development.Study IV was a prospective cohort study investigating perceived self-efficacy in unemployed young adults (n= 249) aged 19-29 year with disabilities, and the association between self-efficacy and transition to work or studies. The study used questionnaire- and registry data from a vocational rehabilitation project. Higher levels of self-efficacy were associated with increased odds for ‘transition to work’. General self-efficacy was low, and young adults with lower self-efficacy reported worse self-rated health compared with those with higher self-efficacy.This thesis showed that multidisciplinary assessment with a multimodal intervention had positive effects on self-efficacy. Individually tailored vocational rehabilitation, based on cooperation and motivational interviewing, may be beneficial for individuals on long-term sick leave and the interactions between participants and the professionals may affect participants’ self-efficacy positively. Mental health needs to be considered when targeting self-efficacy in vocational rehabilitation. Furthermore, research is needed to a) clarify which components in the multidisciplinary team intervention can increase self-efficacy, b) study the effects of vocational rehabilitation based on an individual design, cooperation and motivational interviewing on self-efficacy, health and transition to work, and c) develop interventions that can increase self-efficacy and support transition to work/ studies in young adults with disabilities.
|
|
| 4. |
- Bejerholm, Ulrika, et al.
(författare)
-
From national incentives of implementing Individual Placement and Support to the impact on the service users' quality of life, and view on support
- 2015
-
Ingår i: ENMESH 2015 : Eleventh International Conference of the European Network For Mental Health Service Research; Closing the gap between research and policy in mental health. - : ENMESH. ; , s. 153-154
-
Konferensbidrag (refereegranskat)abstract
- Introduction: It is a challenge to translate evidence-based-research into practice in a way that meets the needs of the service users. The effectiveness of the IPS vocational rehabilitation approach in terms of gaining competitive employment is well known. During the last three years, IPS has been widely implemented in Community Mental Health Service in Sweden, with financial support from the government. Within this context, we aimed to investigate the benefits of IPS as experienced by some of the serviceusers in addition to them increasing their job opportunities.Methods: Based on a one group pre-test and post-test design (one year), we administered instruments targeting activity and community integration (POES-S) and quality of life (MANSA) among 117 service users from four sites. We also addressed their satisfactionwith the IPS service (MY VIEW) and therapeutic relationship with the IPS-employment specialist (STAR) after one year. Descriptive and comparative statistics were applied.Results: Significant differences and increase of scores were found between measurement points with regard to both activity and community integration and quality of life. Satisfaction with service and therapeutic relationships were scored well above the midpoint of the scales after one year.Conclusions: The results indicate that national incentives to implement IPSbenefits the way of life of the users and is a valued service.
|
|
| 5. |
- Bejerholm, Ulrika, et al.
(författare)
-
Individual Placement and Support in Sweden-A randomized controlled trial
- 2015
-
Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 69:1, s. 57-66
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Currently there is no evidence on the effectiveness of Individual Placement and Support (IPS) in Sweden. Aims: To determine the effectiveness of IPS on vocational outcomes among people with severe mental illness (SMI) in a Swedish context. A secondary aim was to evaluate a community integration effect. Methods: A randomized controlled trial with a parallel design was used. Mental health outpatients with SMI were randomized to IPS or traditional vocational rehabilitation (TVR) services. The allocation status was assessor-blinded. The primary outcome was competitive employment. All vocational outcomes were collected continuously, and socio-demographic and clinical variables at baseline, 6 and 18 months. The trial is registered with ClinicalTrials.gov: NCT00960024. Results: One hundred and twenty participants were randomized. Eighty seven per cent were assessed after 6 months, and 73% after 18 months. IPS was more effective than TVR in terms of gaining employment at 18-month follow-up (46% vs. 11%; difference 36%, 95% CI 18-54), along with the amount of working hours and weeks, longer job tenure periods and income. Cox regression analysis showed that IPS participants gained employment five times quicker than those in TVR. Ninety per cent of the IPS participants became involved in work, internships or education, i.e. activities integrated in mainstream community settings, while 24% in the TVR group achieved this. Conclusions: IPS is effective in a Swedish context in terms of gaining employment and becoming integrated within the local community. The welfare system presented obstacles for gaining competitive employment directly and it was indicated that internships delayed time to first competitive employment.
|
|
| 6. |
|
|
| 7. |
- Bejerholm, Ulrika, et al.
(författare)
-
Personal recovery within positive psychiatry
- 2018
-
Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 72:6, s. 420-430
-
Tidskriftsartikel (refereegranskat)abstract
- Background: One goal within positive psychiatry is to support the personal recovery of persons with mental illness and providing opportunities for well-being. Aim: The current article aims to introduce readers to the concept of personal recovery and the potential and importance of recovery-oriented services and measures. Methods: A literature review was conducted to help consider the domains of ‘personal recovery’, ‘recovery-oriented services/interventions’, and ‘measures’. A database search was complemented with a web-based search. Both medical subject heading (MESH) terms and free-text search terms were used. Results: Literature from research journals, grey literature, and websites were included. Within this context, recovery does not refer to a cure but involves a process in which a person acts as an agent to develop new goals and meaning in life, despite and beyond limitations posed by the illness and its consequences. A positive focus on recovery is in sharp contrast to historical deterministic and pessimistic concepts of mental illnesses. Recovery-oriented services such as peer support, assertive community treatment, supported employment/education/housing, illness self-management, and decreasing self-stigma are highlighted. A review of 27 measures that focus on personal recovery and promotion of well-being are also discussed. Conclusions: The literature overview presents perspectives and knowledge of how to develop positive psychiatry, how mental health services and their partner organizations may become more recovery oriented and help persons reach well-being and a better quality of life. This study is limited to a narrative review and may precede future systematic reviews.
|
|
| 8. |
- Bejerholm, Ulrika, et al.
(författare)
-
Rasch Analysis of the Profiles of Occupational Engagement in people with Severe mental illness (POES) instrument
- 2015
-
Ingår i: Health and Quality of Life Outcomes. - : Springer Science and Business Media LLC. - 1477-7525. ; 13
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: The Profiles of Occupational Engagement in people with Severe mental illness (POES) instrument was developed to study time use profiles of occupations and measure the extent they are characterized by engagement. However, the dimensional factors are not known. The aim of the present study was to establish the internal construct validity of the POES using the Rasch measurement model. Methods: A sample of 192 outpatients in Sweden was administered the POES and data were subjected to Rasch analysis. Results: The POES showed good fit to the Rasch model after accommodation for local dependency. The nine items had high reliability as measured by person separation index, and no threshold disordering was present. Differential item functioning analysis showed no significant differences across groups of age, sex, diagnosis, or country of origin. Conclusion: The POES is a unidimensional scale that represents a continuum of occupational engagement. The transformed POES sum score can be used on an interval scale to measure status and changes in occupational engagement in mental health practice and research.
|
|
| 9. |
- Bejerholm, Ulrika, et al.
(författare)
-
Supported employment adapted for people with affective disorders—A randomized controlled trial
- 2017
-
Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327. ; 207, s. 212-220
-
Tidskriftsartikel (refereegranskat)abstract
- Background While effective vocational methods for gaining employment exist for people with schizophrenia and similar conditions, no evidence exists with regard to people with affective disorders. We aimed to study the effectiveness of a newly developed Individual Enabling and Support (IES) model adapted for the target group and compared to traditional vocational rehabilitation (TVR). Methods An assessor-blinded randomized controlled trial (RCT) with a parallel design was performed. Sixty-one participants received IES or TVR. The primary outcome was employment rate at 12-month follow-up. Secondary vocational outcomes, depression severity, and quality of life were also studied. Trial register number is ISRCTN93470551. Results IES was more effective for employment compared to TVR (42.4% vs. 4%; difference 38%, 95% CI 0.12–0.55). Significant group differences were present in secondary vocational outcomes (hours and weeks employed, time to employment), and depression severity. The IES-group had significantly lowering in depression scores and increased quality of life scores during the intervention period. Limitations This RCT was limited by the small sample size due to restriction of recruitment to middle-sized cities within geographically diverse sites in southern Sweden. Larger trials are needed, also in primary health care and employment services settings. Conclusions IES is more effective than TVR for attaining employment and improving depressive symptoms. On a societal level, IES closes the time and service gap between treatment and employment, and thus lowers sick-leave costs. © 2016
|
|
| 10. |
- Bergmark, Magnus, et al.
(författare)
-
Complex Interventions and Interorganisational Relationships : Examining Core Implementation Components of Assertive Community Treatment
- 2018
-
Ingår i: International Journal of Integrated Care. - : Ubiquity Press. - 1568-4156 .- 1568-4156. ; 18:4, s. 1-11
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: There is increasing interest in implementing evidence-based integrated models of care in community-based mental health service systems. Assertive Community Treatment (ACT) is seen as an attractive, and at the same time challenging, model to implement in sectored service settings. This study investigates the implementation process of such an initiative.Methods: Interviews were conducted with ACT team members, the process leader, steering group members, and collaboration partners. The “Sustainable Implementation Scale” helped to identify critical implementation components, and these were further explored using the qualitative interview data. The “Tool for Measuring Assertive Community Treatment” addressed programme fidelity, and the initiative’s sustainability was assessed.Results: High-fidelity implementation of ACT in a sectored service setting is possible. Prominent components that facilitated implementation were careful preparations, team members’ characteristics, and efforts by the process leader and the steering group to improve networking. Implementation was hampered by conflicting goals among the involved authorities and a mismatch between the ACT model’s characteristics and existing organisational traditions and regulations.Discussion and Conclusions: Reducing the uncertainty caused by conflicting goals is an important step in improving the implementation of ACT. In order to facilitate implementation, the goals, regulations, and availability of resources should be aligned horizontally and vertically through the involved organisations.
|
|
