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- Boman, Åse, 1957-, et al.
(författare)
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Parents' discursive resources : Analysis of discourses in Swedish, Danish and Norwegian health care guidelines for children with diabetes type 1
- 2012
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 26:2, s. 363-371
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Tidskriftsartikel (refereegranskat)abstract
- The incidence of diabetes type 1 in children, the most common metabolic disorder in childhood, increases worldwide, with highest incidence in Scandinavia. Having diabetes means demands in everyday life, and the outcome of the child's treatment highly depends on parents' engagement and involvement. The aim of this study was to explore and describe discourses in health care guidelines for children with diabetes type 1, in Sweden, Norway and Denmark during 2007-2010, with a focus on how parents were positioned. As method a Foucauldian approach to discourse analysis was applied, and a six-stage model was used to perform the analysis. The findings shows a Medical, a Pedagogic and a Public Health discourse embedded in the hegemonic Expert discourse. The Expert discourse positioned parents as dependent on expert knowledge, as recipients of education, as valuable and responsible for their child's health through practicing medical skills. This positioning may place parents on a continuum from being deprived of their own initiatives to being invited to take an active part and could result in feelings of guilt and uncertainty, but also of security and significance. From this study we conclude that guidelines rooted in the Expert discourse may reduce opportunities for parents' voices to be heard and may overlook their knowledge. By broadening the selection of authors of the guidelines to include patients and all professionals in the team, new discourses could emerge and the parents' voice might be more prominent. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.
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2. |
- Carlerby, Heidi, 1967-
(författare)
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Health and Social Determinants Among Boys and Girls in Sweden : Focusing on Parental Background
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The majority of Swedish boys and girls have good psychosomatic health. Despite that the risk of mental health problems such as nervousness, feeling low and sleeping difficulties has increased steadily in recent decades. Moreover, previous surveys on health and well-being indicate that boys and girls of foreign extraction in Sweden are at increased risk of ill health compared to boys and girls of Swedish background. The main aim of this thesis was to analyse health and social determinants among boys and girls of foreign extraction in Sweden. The factors explored in papers I–IV include parental background, family affluence and gender and their associations with subjective health complaints, psychosomatic problems or health risk behaviours. Other included risk factors for ill health were involvement in bullying, low participation and discrimination at school. This thesis takes an intersectional perspective, with ambitions to be able to emphasize the interplay between different power relations (i.e. gender, social class and parental background). Two sets of cross-sectional data were used. Three papers were based on the Swedish part of the World Health Organization’s Health Behaviour in School-Aged Children. The sample consisted of 11,972 children (boys n = 6054; girls n = 5918) in grades five, seven and nine from the measurement years 1997/98, 2001/02 and 2005/06. The response rate varied between 85 and 90%. About one fifth of the included children were of foreign extraction. For the fourth paper regional data from Northern Sweden were used. Boys (n = 729) and girls (n = 798) in grades six to nine answered a questionnaire in 2011 and the response rate was 80%. About 14% of the included children were of foreign extraction. Statistical methods used were chi-square test, correlation analyses, logistic regression analyses, cluster analyses and test of mediating factor. The results showed that girls of foreign background were at increased risk of subjective health complaints (SHC) and boys of mixed background were at increased risk of psychosomatic problems (PSP). Increased risk of allocation to the cluster profile of multiple risk behaviour was shown in boys and girls of mixed background, in girls of foreign background and in girls of low family affluence. Increased risk of allocation to the cluster profile of inadequate tooth brushing was shown in boys and girls of foreign background and in girls of low family affluence. General risk factors for increased risk of ill health for boys and girls in Sweden were: any form of bullying involvement, low family affluence, low participation and discrimination at school, of which the latter also was a mediating factor for ill health. Living with a single parent was a risk factor for ill health among girls. The results can function as a basis for developing health promotion programmes at schools that focus on social consequences of foreign extraction, family affluence, participation as well as health risk behaviours and gender.
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