| 1. |
- Draxler, Helena, 1977-, et al.
(författare)
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Changes in Psychiatric Symptoms in Swedish Mothers Who Took Part in Project Support : An Intervention for Mothers Exposed to Intimate Partner Violence With Children Who Have Developed Conduct Problems
- 2023
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Ingår i: Violence against Women. - : Sage Publications. - 1077-8012 .- 1552-8448.
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Tidskriftsartikel (refereegranskat)abstract
- Project Support (PS) is an evidence-based individual support and parenting program developed for mothers exposed to intimate partner violence (IPV) whose children have developed conduct disorders. This Swedish feasibility study focuses on changes in the mothers' psychiatric symptoms, in relation to social and emotional support received as part of PS. In a within-subject design in a naturalistic setting (i.e., 10 social service units), mothers (n = 35) reported a significant decrease in symptoms, but from an individual perspective, most mothers still suffered from clinical levels of psychiatric symptoms. The need for additional interventions for mothers exposed to IPV is discussed.
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| 2. |
- Draxler, Helena, 1977-, et al.
(författare)
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From doubt to trust : Swedish mothers' and counsellors' experience testing a parenting programme for mothers exposed to intimate partner violence whose children have developed behavioural problems
- 2020
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Ingår i: Clinical Child Psychology and Psychiatry. - : Sage Publications. - 1359-1045 .- 1461-7021.
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Tidskriftsartikel (refereegranskat)abstract
- Many countries seek evidence-based interventions for children who have been exposed to domestic violence, and they frequently turn to interventions developed in the US and disseminated to Europe as a solution. Societal and cultural differences may, however, pose barriers to successful implementation. Project Support (PS), piloted in this study through social services agencies in Sweden, has shown positive effects in the US for families with children who have been exposed to intimate partner violence (IPV). The aim of this study was to investigate counselors' and caregivers' experiences when giving/receiving PS in Sweden. The study was based on interviews conducted with 11 mothers and 13 counselors with experience in the programme. A thematic analysis showed three themes (Initial doubts, Confidence from positive change, and Flexibility- challenge for the organization) and the study adds information about obstacles for implementation of PS in Sweden. Cultural and organizational differences between Sweden and the US in practice and child-rearing attitudes are highlighted, as well as the importance of making adjustments while maintaining treatment fidelity, and promoting the dissemination of the approach.
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| 3. |
- Draxler, Helena, 1977-
(författare)
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Initial transfer of Project Support from the US to Sweden : Feasibility and clinical aspects as viewed by counsellors and parents
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Project Support (PS) is a parenting programme developed and studied in the US for parents and children exposed to intimate partner violence (IPV) and for these children with subsequent behavioural problems. By examining feasibility aspects and using qualitative and quantitative methods, the study aimed to explore the transferability of PS to a new naturalistic context, i.e., Swedish social services. In the qualitative Study I, IPV-exposed mothers and counsellors who received/conducted PS were interviewed about their experiences. Study II explored whether the effects of PS in the US, i.e., reduced children’s psychological symptoms and improved parenting capacity among parents and children exposed to IPV, could be replicated in Sweden. Study III explored group and individual impacts of PS on parents regarding aspects of IPV, global psychiatric symptoms, and post-traumatic stress symptoms. Study IV is a qualitative follow-up study where counsellors were interviewed about how the PS work was or was not continued. The results indicate cultural differences between the US and Sweden in practising parenting skills though role-playing and in how to address and understand child misbehaviour, necessitating adaptation to Swedish values and norms. Results further indicate that PS is a promising intervention for Swedish IPV-exposed parents and their children with behavioural problems, leading to improved parental capacity and decreased child behavioural problems, supporting prior research in an American context. PS generally seems to improve parents’ psychiatric symptoms, but examining each individual revealed that most parents still had dysfunctional levels of symptoms post treatment. Maintenance and use of PS was inconsistent, due to lack of organisational support. The study indicates that PS can be further implemented and evaluated in Sweden, and stresses the importance of conducting feasibility studies when an intervention is to be transferred to a new context.
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| 4. |
- Helldin, Lars, et al.
(författare)
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Neurocognitive variability in schizophrenia spectrum disorders : relationship to real-world functioning
- 2020
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Ingår i: Schizophrenia Research. - : Elsevier. - 2215-0013. ; 20, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Neurocognitive variability exists within the schizophrenia spectrum disorder (SSD) population, with subgroups performing at the same level as healthy samples Here we study the relationship between different levels of neurocognitive responding and real-world functioning. The participants were 291 SSD patients and 302 healthy controls that were assessed with a comprehensive neurocognitive battery. In addition, the patients were assessed with the Specific Level of Functioning Scale (SLOF). The results showed that the mean neurocognitive test responses of the SSD group were significantly below that of the control group. However, there was considerable overlap between the cognitive scores of the two groups, with as many as 24% of the patients performing above the mean healthy score for some domains. Moreover, the patients with the highest level of neurocognitive functioning reached the highest levels of practical and work-related functioning outcome skills. There was no significant relationship between neurocognitive and social function skills. The large differences in cognitive performance and their associations with functional outcome within the patient group are rarely addressed in clinical practice, but indicate a clear need for individualized treatment of SSD. Early identification of cognitive risk factors for poor real-life functional outcome is necessary in order to alert the clinical and rehabilitation services about patients in need of extra care.
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| 5. |
- Johansson, Madeleine, et al.
(författare)
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Cognitive markers related to long-term remission status in Schizophrenia Spectrum Disorders
- 2020
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Ingår i: Psychiatry Research. - : Elsevier. - 0165-1781 .- 1872-7123. ; 289
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Tidskriftsartikel (refereegranskat)abstract
- Cognitive impairment is an established feature of schizophrenia. From a cross-sectional perspective, studies have revealed associations between cognition and remission. Few studies have examined this relationship longitudinally. Here we examine which cognitive domains might be related to long-term remission and symptomatic severity. The present study followed 173 outpatients with schizophrenia for five years, divided into groups based on long-term remission status and symptomatic severity, assessed with the Positive and Negative Syndrome Scale. Cognitive functioning was assessed at baseline, with tests of vigilance, executive functions, processing speed, memory and learning, working memory, and premorbid functioning. Cognitive domains related to long-term remission status were executive functions, working memory, and premorbid functioning. The most prominent cognitive differences were found between the group in stable remission with minimal symptoms, and the non-remission group, the first group demonstrating better cognitive functioning. The study highlights the role of premorbid functioning as a cognitive feature in the prediction of long-term remission. It also indicates the possibility of viewing specific cognitive domains as markers for clinical outcome, highlighting the value of early assessment of cognition. In summary, a certain cognitive profile, in coexistence with long-term non-remission, suggests poorer outcome. Hence, this group is in need of increased support.
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| 6. |
- Johansson, Madeleine, et al.
(författare)
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Exploring cross-sectional and longitudinal symptomatic remission and subjective quality of life in Schizophrenia
- 2023
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Ingår i: Psychiatry Research. - : Elsevier. - 0165-1781 .- 1872-7123. ; 328
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Tidskriftsartikel (refereegranskat)abstract
- Achieving symptomatic remission, as defined by the Remission in Schizophrenia Working Group, is intended tobe a meaningful outcome for individuals with schizophrenia, resulting in enhanced well-being. Cross-sectionalstudies have reported an association between symptomatic remission and subjective quality of life (QoL). Longitudinal studies aimed at examining this association have showed mixed results. The aim of this study was toexplore the relationship between symptomatic remission and subjective QoL, both cross-sectionally andlongitudinally. The study comprised data from what were at most 386 patients with schizophrenia, of whom 122–140 werefollowed over a period of four years. Based on cross-sectional remission status and longitudinal remissionpattern, differences in subjective QoL were explored. Remission status was assessed using the Positive andNegative Syndrome Scale (PANSS), and subjective QoL using the Short Form-36 Health Survey (SF-36). Both the cross-sectional and the longitudinal approach showed that patients in symptomatic remission hadsignificantly higher subjective QoL. Patients who were in non-remission at baseline, but who achieved remissionat follow-up, also had significantly higher subjective QoL at follow-up compared with baseline. The results from the study show a clear association between symptomatic remission and subjective QoL. However, achieving symptomatic remission does not appear to be a guarantee of sustained subjective QoL, andonly continued stable remission appears to result in such an outcome.
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| 7. |
- Johansson, Madeleine
(författare)
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Longitudinellt perspektiv på symtomatisk remission vid schizofreni
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Objective: The overall aim of this thesis was to investigate the remission criteria according to the Remisson in Schizophrenia Working Group (RWSG), mainly from a longitudinal perspective.Paper I showed that all remission symptoms in the RSWG criteria, affected the remission status in the cross-sectional setting. In the longitudinal setting, the symptoms Delusions and Hallucinatory behavior contributed mostly to the fluctuation between remission and non-remission, while negative symptoms were more prominent in the group that never reached remission. Finally, the sustainability of remission was significantly longer when only minimal symptom intensity occurred, compared with mild.Paper II showed that the cognitive areas associated with long-term remission pattern were executive functioning, working memory and verbal functioning, where significant better results were shown in the group of stable remission with only minimal symptoms compared to the group never reaching remission. Verbal functioning was the only cognitive area that could predict long-term remission pattern, as a better result increased the probability of being in long-term remission.Paper III focused on the patient’s perspective and examined the relationship between subjective quality of life (SQoL) and remission. The paper showed significant associations between a better SQoL, self-assessed with Short Form Health Survey-36, and both cross-sectional remission and long-term. A significant better SQoL was present regardless of being in stable remission over time or if remission was reached during the study period.Conclusions: The thesis support that the RSWG criteria for remission is a valuable concept, also from a longitudinal perspective. Taken together, the results emphasize the heterogeneity of schizophrenia, where different groups within the disorder show different clinical characteristics. This thesis highlights the importance of regular assessments of broad clinical status, to support a higher frequency and sustainability of remission.
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| 8. |
- Lindgren Fändriks, Anna, et al.
(författare)
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Child health care nurses' experience of language screening for 2.5-year-old children : A qualitative study
- 2023
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Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 10:9, s. 6583-6591
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate the experience of Child Health Care Nurses (CHCNs) using language screening for 2.5-year-old children.Design: An exploratory qualitative design with an inductive approach.Method: Data were collected through semi-structured, interviews with Swedish CHCNs who regularly performed language screening for children. The interviews were analysed by thematic analysis.Results: Four themes were identified: 'The difficult visit', 'Explanations for language delay', 'Language screening across cultures' and 'Language screening with children exposed to adverse life events'.Patient or Public Contribution: Our findings suggest that in routine care a modified procedure is used for the language screening of children aged 2.5 to secure the child's cooperation and to preserve an alliance with the parents. Consequently, the validity of the screening is called into question, particularly when it comes to children from families with origins outside the dominant culture and children exposed to adverse life events.
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| 9. |
- Terp, Ulrik, 1968-, et al.
(författare)
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A feasibility study of a cognitive behavioral based stress management intervention for nursing students : results, challenges, and implications for research and practice
- 2022
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Ingår i: BMC Nursing. - : BioMed Central. - 1472-6955. ; :1
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Tidskriftsartikel (refereegranskat)abstract
- Background Stress related psychological problems are growing in nursing education and constitute an essential challenge for educators. This makes research about strategies and interventions to meet these problems important. Stress management interventions need to be tested for feasibility and acceptability, before conducting large scale RCTs. The objective of our study was to assess the feasibility and acceptability of a newly developed cognitive behavioral stress management intervention for nursing students. Methods Data were collected using a combination of standardized measurements and newly created questionnaires in combination with qualitative data. Our data included recruitment capability, sample characteristics, intervention acceptability and preliminary evaluation of participant psychological changes. Results Findings suggested that the feasibility of conducting a full-scale evaluation was confirmed for intervention acceptability, data collection procedures, and adherence. However, difficulties relating to recruitment capability and homework were identified. All aspects taken together, the intervention was found feasible and acceptable to nursing students, and thus a potential stress management intervention for the nurse education context. Conclusions Overall, this study provides an insight into the challenges and complexities of developing and evaluating a new brief cognitive behavioral based stress management training intervention in a nurse education setting.
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| 10. |
- Wagman, Petra, et al.
(författare)
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Associations between occupational performance, occupational satisfaction, quality of life and occupational balance in people with depression and/or anxiety
- 2021
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Konferensbidrag (refereegranskat)abstract
- Background: Anxiety and depressive disorders are common in western societies and related to occupational problems.Objective: To describe occupational balance in people with anxiety and/or depression and associations with higher occupational balance.Methods: Clients (20 men and 98 women), aged 18 to 65 years were recruited from outpatient mental health care or primary health care. They had a diagnosis of anxiety and/or depression as well as occupational problems.The participants answered questionnaires about occupational balance, occupational performance, satisfaction with occupational performance, quality of life, and psychological problems.Results: The participants rated generally low occupational balance. However, the level of occupational balance differed depending on their self-rated level of anxiety and depression; quality of life; occupational performance; and satisfaction with the occupational performance.High occupational balance was, in a logistic regression, associated with high satisfaction with occupational performance, high quality of life, and low level of depression.Conclusion: The results indicate that satisfaction with occupational performance is a relevant aspect in relation to occupational balance in clients with anxiety and depression.
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| 11. |
- Wagman, Petra, et al.
(författare)
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Factors associated with higher occupational balance in people with anxiety and/or depression who require occupational therapy treatment
- 2021
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Taylor & Francis. - 1103-8128 .- 1651-2014. ; 28:6, s. 426-432
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Tidskriftsartikel (refereegranskat)abstract
- Background: Anxiety and depressive disorders are associated with problems with everyday occupations, including difficulties achieving occupational balance. The aim of this cross-sectional study was to describe occupational balance in people suffering from anxiety and/or depression and the factors that are associated with better self-rated occupational balance. Material: One hundred and eighteen participants were recruited from outpatient mental health care and primary health care. The participants were 18-65 years, had a diagnosis of anxiety and/or depression, and had problems in everyday occupations. They answered questionnaires on occupational balance, psychological symptoms, quality of life and everyday occupations. Results: A generally low rating of occupational balance was found; however, the scores differed depending on the participants' degree of anxiety and depression, their quality of life, their occupational performance and satisfaction with their occupational performance. Logistic regression analyses revealed that high quality of life, high satisfaction with occupational performance and low level of depression were associated to occupational balance. Conclusion: The results indicate that enhanced satisfaction with life and with performance of everyday occupations are relevant factors for achieving occupational balance in clients diagnosed with anxiety and/or depression.
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| 12. |
- Wagman, Petra, et al.
(författare)
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Quality of life, sense of coherence and occupational balance one year after an occupational therapy intervention for people with depression and anxiety disorders
- 2023
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Ingår i: Work. - : IOS Press. - 1051-9815 .- 1875-9270. ; 76:2, s. 561-568
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Quality of life (QOL), sense of coherence (SOC) and occupational balance (OB) have been found to increase after rehabilitation among people living with depression and anxiety. However, these aspects have not been investigated over time in participants with different paid work situations, such as being on sick leave or not. OBJECTIVE: To describe and compare the self-rated QOL, SOC and OB after participation in occupational therapy in three groups of people with depression and anxiety disorders based on their work situation during the study period: continuous sick leave, return to work and continuous work. METHODS: Forty-seven women and seven men, 19-60 years old with depression and anxiety were followed over time. They completed questionnaires on QOL, SOC and OB on four occasions. Data were analyzed with non-parametric statistics. RESULTS: No statistically significant differences between the groups were identified. All groups improved in at least one of the studied areas over time: the sick leave group in OB; the return-to-work group in QOL and OB; and the Work group in QOL and SOC. CONCLUSION: The results indicate variations in QOL, SOC and OB between people with different work situations over time after occupational therapy. Studies with larger samples are, however, warranted.
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| 13. |
- Wirsén, Erik, et al.
(författare)
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Burdens experienced and perceived needs of relatives of persons with SMI : A systematic meta-synthesis
- 2020
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Ingår i: Journal of Mental Health. - : Taylor & Francis. - 0963-8237 .- 1360-0567. ; 29:6, s. 712-721
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: Close relatives of people with severe mental illness (SMI) experience problems known as family burdens. In addition, they may have their own needs for support, something often overlooked by the healthcare system. Meta-syntheses in this area may help explore the meaning of the experience of living with someone who has a SMI.AIM: Our aim was to describe the burdens experienced and needs perceived on a daily basis by relatives to someone who has a SMI.METHODS: The databases PubMed, CINAHL, and PsychInfo were searched using a systematic search strategy. Studies were screened for relevance and quality was appraised. A meta-synthesis of nine qualitative studies was then conducted.RESULTS: The nine studies discerned the following themes. Burden themes; Forced to carry a sometimes unbearable burden; Burdened by own ill-health and disrupted relationships; Distressed and stigmatized by society. Needs themes; strengthening protective factors; Skills and practical support greatly appreciated.CONCLUSIONS: The burdens and needs of relatives of persons with SMI strongly influence their lives. They require relief from both practical and emotional burdens. Family interventions and other programs to support relatives should be encouraged with this knowledge in mind.
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