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- Haraldsson, Johanna, 1976-
(författare)
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Exploring adolescent males’ consultations with general practitioners in the context of psychosocial health
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis aimed to explore adolescent males’ experiences of consultations with general practitioners (GPs) with a particular focus on confidentiality in relation to poor mental health and health-compromising behaviours.First, a model describing the covariation of poor mental-health symptoms, associated somatic symptoms, and health-compromising behaviours was developed through explorative and confirmative factor analysis (paper I). The model was then applied in a structural equation modelling approach to study whether these symptoms and behaviours influenced how adolescent males valued and experienced confidentiality as well as whether they were comfortable asking sensitive questions during their GP consultations (paper II).Next, to gain a deeper understanding, adolescent males’ experiences with GP consultations were further explored through a qualitative lifeworld-based approach. Interviews were analysed with thematic analysis (paper III) and video observations with a phenomenological–hermeneutical method (paper IV). The findings revealed that by providing confidentiality, here defined as private time without parents and explaining the meaning and boundaries of professional secrecy, GPs can facilitate discussions on sensitive topics and make adolescent males feel more comfortable to raise their own concerns. This might be a fruitful approach to address any unmet health needs, which can be achieved through the split-visit consultation model.Another finding was that the studied consultations were very complex. Due to their ongoing development, inexperience with GP consultations, and notions of masculinity, the adolescent males struggled with cognitive, emotional, and relational difficulties while negotiating their right to define the problem and be responsible for their health. The adolescent males emphasized the importance of being listened to and taken seriously, which entails that all aspects of the consultation must be adapted to their individual needs and to their lifeworld. This aligns with Larsen’s consultation model, where the GP strives to understand the patient’s experience and to connect their medical findings to the patient’s lifeworld. Given that both the split-visit consultation model and Larsen’s consultation model offer valuable frameworks for addressing essential, but different, aspects in adolescent males’ GP consultations, the thesis proposes a synthesis of the two approaches.
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| 2. |
- Nygren, Ulrika Svea, et al.
(författare)
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Team-based visits within Swedish child healthcare services : a national cross-sectional study
- 2024
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Ingår i: Journal of Interprofessional Care. - : Taylor & Francis. - 1356-1820 .- 1469-9567.
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Tidskriftsartikel (refereegranskat)abstract
- Complex healthcare needs can be met through effective interprofessional collaboration. Since 2014, Swedish Child Healthcare Services (CHS) include universal team-based visits with a nurse and a physician who perform such visits at the age of 4 weeks, 6 months, 12 months, and 2.5 to 3 years, as well as targeted team-based visits to address additional needs. The aim of this study was to describe the prevalence of team-based visits in the Swedish CHS and possible associations between team-based visits and contextual factors that may affect its implementation. A national cross-sectional survey was conducted using a web-based questionnaire distributed to all reachable nurses, physicians, and psychologists (n =3,552) engaged in the CHS. Data were analyzed using descriptive statistics and binary and multivariate logistic regressions. The response rate was 32%. Team-based visits were reported by 82% of the respondents. For nurses and physicians, the most frequent indication was specific ages, while for psychologists it was to provide parental support. Respondents working at Family Centers were more likely to perform team-based visits in general, at 2.5 to 3 years and in case of additional needs, compared to respondents working at Child Health Centers (CHC) and other workplaces. In conclusion, team-based visits are well implemented, but the pattern differs depending on the contextual factors. Targeted team-based visits and team-based visits at the age of 2.5 to 3 years are most unequally implemented.
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