| 1. |
- Engh Kraft, Lisbet, 1954-, et al.
(författare)
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School Nurses Avoid Addressing Child Sexual Abuse
- 2017
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Ingår i: Journal of School Nursing. - : SAGE Open. - 1059-8405 .- 1546-8364. ; 33:2, s. 133-142
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Tidskriftsartikel (refereegranskat)abstract
- Child sexual abuse (CSA) is a global public health problem with major consequences for the individual child and society. An earlier Swedish study showed that the school nurses did not initially talk about nor mention CSA as one form of child abuse. For the child to receive adequate support, the disclosure is a precondition and is dependent on an available person prepared to listen. The aim of the study was to explore the ability of the school nurses to detect and support sexually abused children. It is a secondary analysis of focus group interviews with school nurses. Thematic analysis was performed. Results showed that the school nurses avoided addressing CSA due to arousal of strong emotions, ambivalence, and a complicated disclosure process. In order to detect CSA and support abused children, attentiveness of sexual abuse as a possible cause of physical and mental illhealth is crucial.
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| 2. |
- Engh Kraft, Lisbet, et al.
(författare)
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The School Nurse's Ability to Detect and Support Abused Children : A Trust-Creating Process
- 2015
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Ingår i: Journal of School Nursing. - : Sage Publications. - 1059-8405 .- 1546-8364. ; 31:5, s. 353-362
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Tidskriftsartikel (refereegranskat)abstract
- Child abuse has negative health consequences. Early detection and preventive measures lead to avoidance of prolonged and more complex problems. School nurses have a child protection role and should pay attention to vulnerable children. Through health dialogues and other interactions with pupils, school nurses have the opportunity to detect child abuse. The aim of the study was to explore how school nurses detect child abuse and initiate support measures. Focus group interviews were conducted with 23 school nurses. The data were analyzed using a grounded theory approach. Results showed that the main concern of the school nurses was support and assistance to children who are abused which was preceded by a trust-creating and trust-strengthening process. Trust contains self-confidence and confidence in the system and trust can be strengthened or undermined. Building trustful relations is time consuming and is facilitated by networking, refined assessment instruments, and collaboration.
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| 3. |
- Engh, Lisbet, 1954-, et al.
(författare)
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Can school attachment modify the relation between foster care placement and school achievement?
- 2018
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Ingår i: British Journal of School Nursing. - : Mark Allen group. - 1752-2803 .- 2052-2827. ; 13:4, s. 175-185
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this research is to examine the relation between school attachment and school achievement and foster care placement.A cross-sectional study was carried out with data from 20 340 pupils in Sweden, aged 10, 13 and 16 years, 252 of the children were placed in foster care.Data on children's health, school attachment and school achievement were obtained from the Pupil Health Database.The results show that school achievement was significantly poorer for children in foster care than for other children, but only when they had low school attachment. When they had high school attachment, there was no difference in school achievement between the groups. Therefore, the results of this study suggests that school attachment could modify the relation between foster care placement and school achievement. The interaction effect was statistically significant after adjusting for age and sex. By promoting school attachment for children in foster care through creating supportive relations and a friendly school environment, the school achievement can be improved.
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| 4. |
- Engh, Lisbet, 1954-
(författare)
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Skolsköterskans möjlighet att upptäcka och stödja barn som far illa eller riskerar att fara illa
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Since children are a vulnerable group, the society has a special responsibility to protect them. The school nurse sees all pupils at school at regular health visits and thereby gains knowledge of their health and living conditions. The overall aim of the thesis was to develop empirical knowledge and understanding of the ability of the school nurse to detect and support children who are maltreated or at risk to be maltreated. The thesis is based on four studies. Study I was based on focus group interviews with school nurses. Data was analysed in accordance with Grounded Theory. Study II was a secondary analysis of study I and performed with Thematic Analysis. Studies III and IV were based on population data which was analysed by univariate and multivariate logistic regressions. The results showed that the school nurse has ability to detect children who are maltreated or at risk to be maltreated. However, also obstacles for detection were found such as lack of trust, avoidance, strong feelings and insufficient documentation. The obstacles were partly due to organisational shortcomings and dearth of resources affecting also internal and external collaboration. The school nurse strived for building trustful relations to pupils, to parents and to professionals. If the school nurse failed to report suspected child maltreatment to the child protection services it was because of worries that the reporting did not benefit the child. The school nurse avoided addressing child sexual abuse because of its particular sensitiveness, which affected the possibility to detect the abuse. Pupils in foster care were at higher risk of health problems, a more risky lifestyle, a lower degree of school attachment and lower school performance compared to pupils not in foster care. The results emphasize the potential of the school nurse to detect and support maltreated children through regular contacts with pupils, their confidence in the school nurse and trustful relations with other professionals.
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| 5. |
- Engh, Lisbet, 1954-, et al.
(författare)
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Swedish population-based study of pupils showed that foster children faced increased risks for ill health, negative lifestyles and school failure.
- 2017
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Ingår i: Acta Paediatrica. - : Wiley-Blackwell. - 0803-5253 .- 1651-2227. ; 106:10, s. 1635-1641
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This population-based study explored whether foster children faced a higher risk of health problems than children of the same age who were not in foster care.METHODS: Data for 13 739 pupils aged 10, 13 and 16 years were obtained from the Pupil Health Database in the county of Värmland, Sweden, for the school years 2012/2013 and 2013/2014. These included data on school performance, health, lifestyle and social relationships, based on children's interviews with school nurses.RESULTS: Of all the pupils, 171 (1.2%) were in foster care. Children in foster care were generally unhealthier than other children. Both girls and boys were at higher risk of chronic health problems, daily smoking, use of drugs and school failure. When the girls in foster care were compared to other girls, we found that they faced a higher risk of psychological and psychosomatic symptoms. This difference was not found for boys. Foster children were also more likely to express a more negative view on life.CONCLUSION: We confirmed earlier studies that children in foster care tended to have inferior health and well-being than other children. These findings emphasise that health, risky behaviour and school performance should be considered together when assessing foster children.
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| 6. |
- Furenäs, Eva, et al.
(författare)
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Effect of maternal age and cardiac disease severity on outcome of pregnancy in women with congenital heart disease
- 2017
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273. ; 243, s. 197-203
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is an increasing prevalence of women with congenital heart defects reaching childbearing age. In western countries women tend to give birth at a higher age compared to some decades ago. We evaluated the CARdiac disease in PREGnancy (CARPREG) and modified World Health Organization (mWHO) risk classifications for cardiac complications during pregnancies in women with congenital heart defects and analyzed the impact of age on risk of obstetric and fetal outcome. Methods: A single-center observational study of cardiac, obstetric, and neonatal complications with data from cardiac and obstetric records of pregnancies in women with congenital heart disease. Outcomes of 496 pregnancies in 232 women, including induced abortion, miscarriage, stillbirth, and live birth were analyzed regarding complications, maternal age, mode of delivery, and two risk classifications: CARPREG and mWHO. Results: There were 28 induced abortions, 59 fetal loss, 409 deliveries with 412 neonates. Cardiac (14%), obstetric (14%), and neonatal (15%) complications were noted, including one maternal death and five stillbirths. The rate of cesarean section was 19%. Age above 35 years was of borderline importance for cardiac complications (p = 0.054) and was not a significant additional risk factor for obstetric or neonatal complications. Both risk classifications had moderate clinical utility, with area under the curve (AUC) 0.71 for CARPREG and 0.65 for mWHO on cardiac complications. Conclusions: Pregnancy complications in women with congenital heart disease are common but severe complications are rare. Advanced maternal age does not seem to affect complication rate. Existing risk classification systems are insufficient in predicting complications. (C) 2017 Elsevier B.V. All rights reserved.
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| 7. |
- Haque, M. Atiqul, et al.
(författare)
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Bangladeshi school-age children's experiences and perceptions on child maltreatment : A qualitative interview study
- 2017
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Ingår i: Child Care Health and Development. - : John Wiley & Sons. - 0305-1862 .- 1365-2214. ; 43:6, s. 876-883
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundChild maltreatment (CM) is a public health problem and is recognized as a huge barrier for child development. Most of the research and definitions on CM are from the perspective of high-income western countries. Because no major studies have been conducted on CM in Bangladesh, the aim of the current study was to explore the experiences of and perceptions on CM in school-age children in rural and urban Bangladesh in order to understand maltreatment in a local context and from a child perspective. MethodsSemistructured individual interviews with 24 children (13 boys and 11 girls), between the ages of 9 and 13years of which 11 were schoolgoing and 13 non-schoolgoing, were conducted during July 2013 and analysed according to qualitative content analysis. ResultsCM was a common and painful experience with serious physical and emotional consequences but highly accepted by the society. Vulnerable groups were especially young children, girls, and poor children. The children's voices were not heard due to their low status and low position in their families, schools, and working places. The main theme that emerged in the analysis was children's subordination, which permeated the five categories: (a) perception of children's situation in society, (b) understanding children's development and needs, (c) CM associated to school achievement, (d) negative impact of CM, and (e) emotional responses. ConclusionsDifferent kinds of abuse are obviously common in Bangladesh, and the schools do not follow the law from 2011 prohibiting corporal punishment at school. The society has to take further steps to live up to the UN Convention on the Rights of the Child, which was ratified already in 1990, to protect the Bangladeshi children from CM.
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| 8. |
- Haque, Md. Atiqul, 1970-
(författare)
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Child Maltreatment in Bangladesh : Perceptions, Prevalence and Determinants
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Like most low- and middle-income countries Bangladesh have no prevalence data on Child Maltreatment (CM) and lack a reporting system.Objectives: The overall aims of the thesis were to generate knowledge on CM in the Bangladeshi society and to estimate the prevalence and associated risk factors.Methods: The thesis is based on four studies. In Study I children’s experiences were explored and 24 school aged children were interviewed. Qualitative content analysis was used for data analysis. In Study II 790 newspaper articles on CM from six national daily newspapers were selected during three months in 2014. Data were analysed through descriptive content analysis. Studies III and IV were cross-sectional population surveys. The International Child Abuse Screening Tool for Children (ICAST-C) was translated for data collection. Face-to-face interviews were performed during March-April 2017 with 1,416 children aged 11-17 years. In Study III the prevalence and risk factors of child physical abuse (CPA) were estimated, while in Study IV the same for child psychological abuse (CPsyA) and neglect.Results: CM was a common and painful experience with serious physical and emotional consequences but highly accepted by the society. Vulnerable groups were young children, girls, and poor children (Study I). Physical and sexual abuse were the most common types of CM covered in the news articles. One third of the reported cases resulted in death. Boys were victims of physical abuse to a higher degree, while girls were reported as victims of sexual abuse. The identity of the victims was often disclosed (Study II). Approximately all children reported experiences of CPA and CPsyA. Neglect was less reported (Study III and IV). Boys, younger children, victim of family violence, and low maternal education were risk factors of CPA (Study III). Not living with parents, working, family size and victim of family violence were risk factors of CPsyA or neglect. More years of schooling was a protective factor (Study IV).Conclusions: The results show that almost every child in Bangladesh experience CM. The studies incorporated in this thesis contribute to the knowledge on CM in the Bangladeshi cultural context.Key words: Child Maltreatment, ICAST-C, Public Health, Bangladesh
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| 9. |
- Haque, M. Atiqul, et al.
(författare)
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Children's exposure to physical abuse from a child perspective : A population-based study in rural Bangladesh
- 2019
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:2
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Tidskriftsartikel (refereegranskat)abstract
- Background Although child physical abuse (CPA) is considered as a major global public health problem, it has not yet been recognized as such in Bangladesh. Very few studies have assessed the prevalence and victims' characteristics of multiple forms of CPA. Objective This population-based study assessed the prevalence of CPA committed by adults in a rural area of Bangladesh and examined its association with demographic and socio-contextual factors. Methods Data were obtained using ISPCAN Child Abuse Screening Tool for Children (ICAST-C) in a random sample of 1416 children (49% girls, 51% boys) aged 11 to 17 years by face-to-face interviews during March-April 2017. The response rate was 91.5%. To estimate predictors of CPA, physical abuse was categorized into frequent and less frequent groups. Results The prevalence of at least one form (>= 1), two forms (>= 2) and three or more forms (>= 3) of CPA were estimated approximately to 99%, 95% and 83% in their lifetime and 93%, 79%, and 57% in the past year respectively. Hitting (except on buttocks), standing/kneeling and slapping were the most common physical abuse whereas given drugs or alcohol, pinched, burned or scalded, beaten-up and locked up were less reported. Female children were faced severe forms of CPA more than that of males. Male children, younger age groups, witnessing adults using weapons at home, bullied by siblings and low level of maternal education were found to be significant risk factors for both >= 1 form and >= 2 forms of frequent CPA whereas adding also adult shouting in a frightening way was found as a significant risk factor for >= 2 forms of frequent CPA. Conclusion Self-reported prevalence of CPA is extremely common in the Bangladeshi rural society. The prevalence was associated with demographic and socio-contextual characteristics of the children such as being younger, witnessing domestic violence and maternal low education. The findings provide evidence to support parents and policy-makers to take effective measures to implement policy and programme on alternative up-bringing methods and creating awareness of negative effects of CM which in turn help Bangladesh to line up with UN Convention on the Rights of the Child, which the country signed in 1990.
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| 12. |
- Nilsson, Ulf, et al.
(författare)
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The prevalence of prolonged QTc increases by GOLD stage, and is associated with worse survival among subjects with COPD
- 2019
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Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 48:2, s. 148-154
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Tidskriftsartikel (refereegranskat)abstract
- Background: The role of QTc-prolongation, in relation to the increased mortality in COPD, is unclear. Objectives: To estimate the prevalence and prognostic impact, assessed as mortality, of QTc-prolongation in COPD, restrictive spirometric pattern (RSP), and normal lung function (NLF), respectively. Methods: All individuals (n = 993) with COPD and age- and sex-matched non-obstructive referents were identified from well-defined population-based cohorts examined in Northern Sweden in 2002-04. In 2005, the study-sample was invited to re-examination including ECG; QTc was calculated and mortality data collected until 31st December 2010. Results: The prevalence of QTc-prolongation was higher among people with RSP than among those with NLF and, although similar in NLF and COPD, the prevalence increased by COPD-severity. Among participants with COPD, those with QTc prolongation had higher mortality than those with normal QTc, while no such differences were found among participants with NLF or RSP. Conclusion: Among participants with COPD, the prevalence of QTc-prolongation increased by disease-severity and was associated with mortality. (C) 2018 Elsevier Inc. All rights reserved.
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