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- Axberg, Ulf, 1961, et al.
(författare)
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Utveckling av bedömningsmetoder för barn som utsatts för våld i sin familj - Rapport från en fortsättningsstudie
- 2018
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Tidigare studier i iRiSk-projektet har utvecklat och prövat metoder för insamling av uppgifter som behövs för bedömning av hur stor risk barn som varit utsatta för våld i sin familj löper att utsättas för förnyat och/eller förgrovat våld av vuxna som har omvårdnadsansvar för barnet. I dessa studier framkom att det inom socialtjänsten fanns skäl att göra risk-/skyddsbedömningar i cirka 10 procent av alla nya ärenden. Det aktuella iRiSK-projektet har undersökt i vilken grad den tidigare utvecklade metoden för risk-/skyddsintervju och bedömning är praktiskt användbar inom individ-och familjeomsorgen, vilket är första steget i den vetenskapliga process vars nästa steg är att pröva metodens sensitivitet och specificitet. Projektet har också lagt grunden för en prediktionsstudie, vilket det finns ett stort behov av när det gäller barnavårdsärenden, och som hittills inte studerats i en svensk kontext. Syftet med föreliggande projekt var att pröva användbar- och genomförbarheten av iRiSk-intervjuerna inom ramen för barnavårdsutredningar avseende barn som varit utsatta för våld i sin familj, direkt och/eller bevittnat mellan barnets föräldrar, ur barns, föräldrarnas och handläggares perspektiv. Vidare syftade projektet till att utveckla den befintliga iRiSk-intervjun med föräldrar så att den riktar sig till såväl våldsutövande som våldsutsatta föräldrar och i en pilotstudie pröva hur den fungerar i den sociala barnavårdens kontext. Datainsamlingen har pågått under sju månader (perioden 1 maj till 31 december) 2017. När pilotprojektet inleddes var planen att teckna avtal med 6-7 enheter inom socialtjänstens individ och familjeomsorg (IFO) där varje enhet förväntades kunna göra 5 till 10 intervjuer under projektperioden. På grund av ändrade förutsättningar i de verksamheter som forskargruppen haft en längre kontakt med samt att vissa av verksamheterna behövt en längre period att komma igång med intervjuerna än planerat kom det i praktiken att bli två enheter som deltog i prövningen av intervjun. Vid dessa verksamheter har ca 25 intervjuer genomförts under perioden, varav ett mindre antal blivit tillgängliga för forskarna. Datainsamlingen innebär att det i skrivande stund finns 19 iRiSk barnintervjuer tillgängliga för fördjupade studier genom samtalsanalys. Under projekttiden har en anpassad version av intervjuguiden utarbetats, som ska kunna användas även med våldsutövande föräldrar. Denna anpassade version har prövats i en pilotstudie vid en verksamhet, i intervjuer med föräldrar som misstänks utöva våld eller där det är konstaterat att de utövat våld. För att utveckla stödet till handläggarna i bedömningen av i vilka ärenden det är lämpligt att använda intervjun med fokus på våldsutövande föräldrar har det strukturerade frågeformulär för fördjupad kartläggning som ingår i metoden reviderats så att de också innehåller frågor om eget våldsutövande. 10 handläggare har intervjuats i grupp för att undersöka hur de ser på metodens användbarhet och i vilken grad de bedömer att den strukturerade intervjun är genomförbar i praktiken. Slutsatserna från projektet är att så långt ser risk-/skyddsintervjuerna ut att fungera väl också i den sociala barnavårdens sammanhang. De intervjuade handläggarna är överlag positiva till metoden och tycker att den är möjlig att använda med barn och föräldrar och att den genererar meningsfull information till barnavårdsutredningen. De har kommit med en rad konkreta förbättringsförslag som tas tillvara vid revidering av materialet. En digital version av materialet är önskvärt då det skulle medge en större flexibilitet i förhållande till olika typer av ärenden, och enkelt avhjälpa en del av de svårigheter som handläggarna beskriver i det praktiska genomförandet av risk-/skyddsintervjuer. Utbildningen av dem som ska använda intervjun behöver utvecklas på flera olika punkter, både i förhållande till det som intervjuade handläggare framför och det som framkommer i samtalsanalysen av de inspelade barnintervjuerna. Den metodkonsultation som erbjudits verksamheter har visat sig vara viktig för att stödja användningen av intervjuerna och formerna för metodkonsultation bör utvecklas. På sikt bör även en utbildnings- och genomförandemanual för risk-/skyddsintervjuerna utvecklas, som tydliggör vilka förkunskaper, vilken utbildning, metodkonsultation och handledning samt organisatorisk förankring som krävs för att intervjuerna ska kunna användas på bästa sätt. Tidigare rapporter från projektet har presenterat resultat av samtalsanalyser av ljudinspelade risk/skyddsintervjuerna med barn. De har beskrivit hur barn hanterar ledande inslag i frågor, hur barns initiativ tas emot av intervjuaren och hur barns ljudinspelade svar är relaterade till vad handläggare skriftligen nedtecknar. Rapporterna har också i bred bemärkelse rapporterat hur barns beskrivningar av svåra upplevelser giltiggörs i intervjusammanhanget. Analysen i denna rapport utgår från ett utökat material (19 intervjuer med barn) och undersöker sammanhanget för intervjuares giltiggörande av barns upplevelser. Valet att titta närmre på giltiggörande och då specifikt kommunikation av förståelse grundar sig bland annat i nya upptäckter i forskningen om vikten av att intervjuer med våldsutsatta barn sker på ett stödjande sätt. Analysen visar att stödjande kan behövas utifrån tidigare upplevelser, att intervjun är påfrestande (tids- och minnesmässigt) och att intervjufrågor kan upplevas ifrågasättande av barn. Intervjuare behöver vara förberedda på dessa svårigheter och ha strategier för att stödja barn, till exempel genom att uttrycka förståelse för barnets känslor. Barn ger oftare uttryck för intervjuupplevelser icke-verbalt och i dessa fall tycks icke-verbala resurser utgöra lämpliga stödjande resurser. Intervjuarens hävdande av emotionell förståelse av tidigare upplevelser leder i denna studie till utvecklade svar. På grund av det relativt lilla material som ingår i studien behöver detta mönster studeras i större skala. I stort sett verkar iRiSk-intervjuerna ge utrymme för ett stödjande förhållningssätt. I handledningen av intervjuare är det dock viktigt att intervjuare får reflektera över olika möjliga bemötanden av barns motstånd i intervjusituationen. När det gäller en utvecklade intervjun för våldsutövande föräldrar pekar kunskapsläget kring risk/skyddsbedömningar som utgår från barns utsatthet och behov på betydelsen av att den intervjuguide med fokus på våldsutövande föräldrar som nu utarbetats fortsatt utvecklas och prövas, i dialog med verksamheter som möter våldsutövande föräldrar. Mot bakgrund av det faktum att forskning om riskbedömning för partnervåld framförallt har fokuserat våldsutövande män, och att det typfall av föräldrar som utövar partnervåld som socialtjänsten kommer i kontakt med är våldsutövande pappor – som har utövat våld mot barnens mamma - har utvecklingsarbetet med intervjun i detta första steg fokuserat den typiska situationen med pappor som utövar våld mot sin partner/barnets mamma och/eller sina barn. Litteraturgenomgången visar att statistiskt grundade riskbedömningsinstrument och strukturerade bedömningar (konsensusbaserade) för bedömning av partnervåld i några fördelar jämfört med ostrukturerade bedömningar. Statistiskt grundade riskbedömningsinstrument och strukturerade bedömningar används inte i barnavårdsärenden i Sverige. Inga specifika intervjuguider som är utvecklade för en pappa som utövar både partnervåld och barnmisshandel har hittats i litteraturgenomgången. Att intervjua en förälder som misstänks ha utsatt sitt barn och/eller barnets andra förälder för våld är ofta en svår uppgift. Strukturerade risk-bedömningsinstrument som bygger på information också från den föräldern som står för (det grövsta) våldet bör vara ett sätt att öka stringensen i dessa beslut, men sådana instrument finns idag inte tillgängliga, vare sig i Sverige eller internationellt. En strukturerad intervju med en misstänkt förövare av partnervåld/barnmisshandel kan troligen utgöra ett viktigt komplement i riskbedömning och beslut om riskhantering (stöd och behandling) i barnavårdsärenden. En riskbedömning blir troligen mera tillförlitlig om även förövaren intervjuas i en barnavårdsutredning. Om pappor ignoreras i utredningarna, riskerar man att mammorna belastas för att inte kunna skydda sina barn från pappor som utövar våld. En strukturerad intervju kan dessutom vara första steget till att en pappa tar emot erbjudande om att förändra sitt våldsbeteende.
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- Hultmann, Ole, et al.
(författare)
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Talking to parents who have abused: Enhancing the child focus in social child welfare investigations about intimate partner violence and child abuse
- 2019
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Ingår i: European Conference on Domestic Violence.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The iRiSk project (insatser och risk-/skyddsbedömningar för våldsutsatta barn) aims to develop structured risk and safety interviews in child welfare investigations. This includes using the violent parent as informant. Existing interviews with perpetrators of partner violence focus on the violence itself and the risk of repeated violence, but they lack relevant aspects of parenting, such as feelings of remorse, how the parent understands the child’s and the adult victim’s reactions to the violence, and whether perpetrators can identify problems that affect their relationship with the child. This paper presents a study that focuses on fathers as perpetrators. It examines 1) the feasibility of the interview, as assessed by professionals 2) to what extent violent fathers are able to reflect on their violent behaviour and its effect on parenting during the structured interview 3) to what extent violent fathers can provide relevant information to a child welfare investigation. The goal of the project is to improve the quality of risk and safety assessments and the protection of vulnerable children by enhancing the child focus in child welfare investigations about intimate partner violence and child abuse. Participants in the project are recruited through the iRiSk project funded by the Swedish National board of Health and Welfare, which test risk assessments with children subjected to child abuse and/or exposed to intimate partner violence. The risk interviews with perpetrators will be tested by professionals within child welfare investigations and with fathers who are in contact with a crisis centre. Recorded interviews with the fathers will be analysed. The structured interview and the outline of the project will be presented as well as preliminary feedback from participating units.
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- Iversen, Clara, 1981-, et al.
(författare)
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Balancing task focus and relationship building : Asking sleepy patients about traffic risk in treatment initiation consultations
- 2017
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 31:4, s. 895-903
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Tidskriftsartikel (refereegranskat)abstract
- Background: The use of traffic risk assessment questions is an understudied area in nursing research. Obstructive sleep apnoea is associated with an increased risk of traffic accidents. Therefore, traffic safety authorities demand adherent continuous positive airway pressure use. Nurses act as coaches to achieve treatment adherence, but they are also obliged to act as state agents by prohibiting obstructive sleep apnoea patients from drowsy driving.Objective: To examine how nurses and obstructive sleep apnoea patients manage traffic risk assessment questions in the relation-building context of treatment initiation consultations.Methods: To study, in detail, the actual practice of risk assessment, we used conversation analysis of 19 video-recorded initial treatment consultations with nurses and recently diagnosed obstructive sleep apnoea patients.Ethics: The study received ethical approval from the Central Ethical Review Board in Linköping (registration number 214/231-32) and follows the ethical guidelines for qualitative research.Results: Patients influence how nurses phrase questions about traffic risk by taking a stance to daytime sleepiness prior to the risk question. Nurses ask traffic risk questions in a way that assumes that driving is unproblematic if patients have not previously indicated problems. It may pose a significant problem when nurses, by accepting patients' prior stance when asking about traffic risk, orient to relationship building rather than task focus.Conclusion: To clarify the difference between their two potentially conflicting roles, nurses need to refer to existing laws and official guidelines when they raise the issue of risk in treatment initiation consultations. Nurses should also ask risk assessment questions in a problem-oriented communicative environment. Traffic risk assessment is sensitive yet important, as obstructive sleep apnoea is a highly prevalent problem causing excessive sleepiness. It is essential to acknowledge nurses' double roles with regard to coaching continuous positive airway pressure treatment and assessing traffic risk.
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| 8. |
- Iversen, Clara, PhD, 1981-
(författare)
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Beyond accessing information : Claiming to understand in child social welfare interviews
- 2019
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Ingår i: British Journal of Social Psychology. - : Wiley. - 0144-6665 .- 2044-8309. ; 58:3, s. 550-568
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Tidskriftsartikel (refereegranskat)abstract
- The present article investigates how people manage understanding of personal experiences in an institutional setting in which shared understanding of one party's experience can become an issue at stake: social welfare interviews with child victims of abuse. New recommendations on how to respond to child interviewees limit interviewers’ support to experiences of which they have direct access. Using conversation analysis and discursive psychology to examine cases in which interviewers respond to children's reports of experiences by claiming to understand, the current article shows that interviewers primarily use such claims after interviewees have indicated that the interviewer may not understand. By claiming to understand, interviewers orient to a difference between an interview requirement – not assuming they know the children's specific experiences – and their ability to interpret the children's situations. The study shows how interviewers use claims of understanding to distinguish themselves as understanding persons from their information‐eliciting approach as social welfare investigators. Findings contribute to social psychological research on how people manage challenges related to eliciting and recognizing experience in interaction. In particular, the study offers research on interviews with child victims of abuse a new angle on the tension between information elicitation and support.
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| 9. |
- Iversen, Clara, PhD, 1981-
(författare)
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Claims of understanding in child social welfare interviews
- 2018
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Konferensbidrag (refereegranskat)abstract
- Claims of understanding in child social welfare risk assessment interviews: the relation between position, turn-‐composition, and interactional work.Clara Iversen(Uppsala Universitty). This study examines interviewers’ claims of understanding in risk assessment interviews with abused children in child social welfare investigations in Sweden. In clinical research about interviewing abused children, mainly conducted within forensic psychology, there is an increased emphasis on the need of a supportive interview climate. While interviewers are still told to avoid claiming to understand interviewees’ past experiences, new recommendations (Herkowitz et al. 2014) suggest that interviewers should claim understanding of children’s interview experiences (e.g., ‘I understand that it is very difficult for you to tell me this’). No interview research has examined in detail the actual work that different variations of understanding claims do in this setting. In other institutional and mundane contexts, studies have shown that psychological terms, such as ‘understand’, are involved in complex activities, related to different agendas (e.g., Weatherall & Keevallik 2016; Lindwall &Lymer 2011). Drawing on this research and findings on stance and affiliation (e.g. Couper-‐Kuhlen 2012), the current study examines the position and composition of interviewers’ claims of understanding in 48 audio-‐recorded social welfare interviews with abused children.The findings show that the two distinct ways in which claims of understanding can be composed in Swedish, with the indexical first or last (‘Det förstår jag’, ‘Jag förstår det’) do different kinds of work. While the former comes in place of a second assessment after interviewees’ displayed stance, the latter is related to closing an interview topic by indexing the interviewers’ candidate understanding. In contrast to recommendations, there were no examples in the data of interviewers claimingto understand children’s interview experiences, but interviewee’s display of upset was attended to with prosody. Unlike formulations or prosody, which show shared understanding, understanding claims treat experiences as sharable, without actually sharing them. They are therefore best understood as a less entitled kind of affiliation, useful when both evaluation and neutrality is a problematic response. The study illustrates how recommendations about interaction, which lack grounding in detailed analysis ofwhat different kinds of ‘supportive’ resources do, may end up advocating practices counter to their agenda. With these findings, the paper aims to contribute to discursive psychological work on how the cognitive thesaurus is used in institutional interaction.
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- Iversen, Clara, 1981-
(författare)
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Safety Last? : Raising Issues of Risk Behavior in Medical Treatment Consultations
- 2016
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Konferensbidrag (refereegranskat)abstract
- Medical interventions evaluate and deal with uncertainty and risk in relation to individual patients’ health. In addition, they may also include measures to protect the general public against consequences of individuals’ conditions. Such measures may be inoculation, anti-smoking campaigns, or assessments of patients’ risk behavior. The present study explores how the double agenda of helping individuals and assessing their risk behavior plays out in medical interactions.The empirical case of this presentation, video-recorded treatment consultations between Obstructive Sleep Apnea (OSA) patients and nurses in Sweden, takes place after a diagnosis is established and doctors and patients have agreed to try a specific treatment. The aim of the encounter is therefore to personalize the treatment and provide a basis for follow-up rather than gaining new information about the patient’s problems. In addition, the consultations include the less patient-focused goal of assessing patients’ risk of falling asleep. OSA is the world’s most common sleep disorder and involves patients’ respiratory airways collapsing during sleep. This often results in recurrent episodes of excessive daytime sleepiness. Consequently, the Swedish Transport Administration states that untreated OSA patients should have their driver’s license confiscated.The study uses conversation analysis to examine how nurses and patients manage the implications of questions concerning the risk to fall asleep involuntarily. The analysis shows nurses conducting a balancing act between risk work on different scales: gaining information as agents for the state and promoting social solidarity with the patient in front of them. It further shows how the participants raise and attend to expertise and experience as different epistemic domains with accompanying rights and responsibilities. I argue that an understanding of risk work benefits from taking into account how different agendas, epistemic responsibilities, and statuses are negotiated in social interaction.
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| 18. |
- Iversen, Clara, 1981-, et al.
(författare)
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Traffic risk work with sleepy patients : from rationality to practice
- 2018
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Ingår i: Health, Risk and Society. - : Taylor & Francis. - 1369-8575 .- 1469-8331. ; 20:1-2, s. 23-42
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Tidskriftsartikel (refereegranskat)abstract
- In this article, we aim to contribute to the emerging field of risk-work studies by examining the relationship between risk rationality and risk practices in nurses’ conversations with Obstructive Sleep Apnoea patients about traffic risks. Legislation in Sweden towards traffic risk involves clinicians making risk assessment of patients prone to falling asleep while driving. In contrast to an overall care rationale, this means that the health of the patient is not the only risk object in treatment consultations. However, guidelines on how to implement legislation are missing. To examine the practical reality of nurses’ traffic-risk work, we draw on an analysis of data from a Swedish study in 2015. This study included qualitative interviews with specialist nurses and video-recorded interactions between nurses and Obstructive Sleep Apnoea patients. We found that a lack of clarity in traffic-risk guidelines on how risk should be addressed was evident in both interview accounts and in observed practice. While nurses primarily accounted for risk work as treatment-relevant education, they practised risk work as interrogation. Patients also treated nurses’ inquiries as assessment – not education – by responding defensively. We conclude that while confusing risk work and treatment enables clinicians to treat patients as competent actors, it obscures the controlling aspects of traffic-risk questions for individual patients and downplays the implications of drowsy driving for general traffic safety.
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| 19. |
- Iversen, Clara, 1981-
(författare)
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Utvärderingsintervjuer
- 2015. - 2
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Ingår i: Barns röster om våld. - Malmö : Gleerups Utbildning AB. ; , s. 213-227
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 21. |
- Iversen, Maura D., et al.
(författare)
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Self-rated walking disability and dynamic ankle joint stiffness in children and adolescents with Juvenile Idiopathic Arthritis receiving intraarticular corticosteroid joint injections of the foot
- 2019
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Ingår i: Gait & Posture. - : ELSEVIER IRELAND LTD. - 0966-6362 .- 1879-2219. ; 67, s. 257-261
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Tidskriftsartikel (refereegranskat)abstract
- Background: Children and adolescents with Juvenile Idiopathic Arthritis (JIA) exhibit deviations in ankle dynamic joint stiffness (DJS, or moment-angle relationship) compared to healthy peers, but the relationship between ankle DJS and self-reported walking impairments has not been studied. This secondary analysis aimed to investigate the relationship between ankle DJS and self-reported walking disability in juveniles with JIA, and to determine whether intraarticular corticosteroid foot injections (IACI) were associated with long term changes in ankle DJS. Research questions: Is ankle DJS altered in children with JIA reporting walking difficulties compared to children with JIA reporting no walking difficulties? Are IACIs associated with persistent alterations in ankle DJS? Methods: Gait dynamics (DJS), foot pain, and foot-related disability were assessed in 33 children with JIA before intraarticular corticoid foot injection (IACI), and three months after IACI. Using self-reported walking capacity scores, children were classified as either having no walking difficulties (ND) or having walking difficulties (WD). Inferential statistics were used to compare demographics, pain, impairment scores, and ankle DJS between the groups. Results: Before treatment, in the WD group, ankle DJS was significantly decreased both in the early rising phase (ERP = 0.03 +/- 0.02 vs. 0.05 +/- 0.02 Nm(kg*deg)(-1)) and late rising phase (LRP = 0.11 +0.06 vs. 0.24+0.22 Nm (kg*deg)(-1)) compared to the ND group. At three months, the ERP was still significantly decreased in the WD group (ERP = 0.03 +/- 0.01 vs. 0.05+0.03 Nm(kg*deg)(-1)). Significance: Among children and adolescents with JIA who reported walking difficulties prior to IACIs, alterations in DJS in early stance phase (decreased ERP) remained three months after IACI suggesting persistent gait adaptations, possibly related to pain. Pre-treatment gait analysis may aid in identifying children who will not have long term benefit from IACIs in terms of improved gait, and therefore, may be informed and have the choice to be spared the risk of side effects associated with this treatment.
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| 22. |
- Naili, Josefine E, et al.
(författare)
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Deficits in functional performance and gait one year after total knee arthroplasty despite improved self-reported function
- 2017
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer. - 0942-2056 .- 1433-7347. ; 25:11, s. 3378-3386
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The current literature lacks sufficient information about improvements in gait patterns and function after total knee arthroplasty (TKA) and whether patients return to full function. This study evaluated change in gait, performance-based function, and self-reported function 1 year after TKA in patients with symptomatic knee osteoarthritis and how these aspects interrelate.METHODS: A total of 28 patients (64 % female) with knee osteoarthritis, with a mean age of 66 (±7) years, and 25 age- and gender-matched controls participated in this prospective cohort study. Three-dimensional gait analysis generated comprehensive measures of kinematic and kinetic gait deviations, respectively. Participants completed the Five Times Sit-to-Stand (5STS) test, and the self-reported questionnaire Knee Injury and Osteoarthritis Outcome Score (KOOS), at baseline prior to surgery and 1 year after TKA.RESULTS: Kinetic gait deviations of both the operated and non-operated limb persisted in patients with knee osteoarthritis at 1 year after surgery, while kinematic gait patterns were comparable to controls. Performance on the 5STS and KOOS scores in patients with knee osteoarthritis improved significantly 1 year after surgery (effect size 0.5-1.5), but did not reach the level of controls. Ten patients with knee osteoarthritis (36 %) exceeded the minimally detectable change on the 5STS.CONCLUSION: Measures of overall gait patterns and the 5STS revealed improvements in function 1 year after TKA, but were not restored to the level of healthy controls. Based on change in 5STS performance, we identified patients with substantial improvements in gait patterns. Self-reported measures of function could not detect differences between patients improving in 5STS performance and those who did not. These findings highlight the use of the 5STS in clinical practice since improvement on this test seems to follow the reduction in gait pattern deviations.LEVEL OF EVIDENCE: II.
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| 23. |
- Naili, Josefine, et al.
(författare)
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The impact of symptomatic knee osteoarthritis on gait pattern and its association with performance-based measures and patient-reported outcomes
- 2017
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Ingår i: Knee (Oxford). - : Elsevier. - 0968-0160 .- 1873-5800. ; 24:3, s. 536-546
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Tidskriftsartikel (refereegranskat)abstract
- Background: Limited knowledge exists regarding the impact of symptomatic knee osteoarthritis (OA) on the overall gait pattern; and whether gait deviations are associated with performance based measures (PBMs) and patient-reported outcomes (PROs). This cross-sectional study evaluated overall gait patterns in patients with knee OA using the Gait Deviation Index for kinematics (GDI) and kinetics (GDI-kinetic), and explored associations between gait deviations, PBMs, and PROs. Methods: Forty patients with knee OA and 25 age and gender-matched controls underwent three-dimensional gait analysis. Participants performed the Timed Up and Go (TUG), Five Times Sit-to-Stand (5STS), and Single Limb Mini Squat (SLMS) tests and completed a disease specific PRO. Associations between gait deviations, PBMs, and PROs were assessed by Pearson's correlation and multiple linear regression. Results: Patients with OA demonstrated significantly lower GDI and GDI-kinetic scores of the OA and contralateral limbs compared to controls; with GDI-kinetic scores on the contralateral limb more impacted than the OA limb. On the contralateral limb, GDI-kinetic score significantly correlated with TUG (r = -0.42) and 5STS (r = -033), while on the OA limb with TUG (r = -0.68), 5STS (r = -0.38), SLMS (r = -0.38), activities of daily living (r = -0.35) and Knee-related Quality of Life (r = -035). No significant associations existed between kinematic GDI scores, PBMs and PROs. Conclusion: The overall gait pattern, as represented by GDI and GDI-kinetic scores, in patients with symptomatic knee OA is affected both on the painful OA limb and the contralateral limb. The GDI and GDI-kinetic scores provide different information regarding function that is not revealed by PBMs or PROs.
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| 24. |
- Westerlund, Michael, et al.
(författare)
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"The hopelessness can be overwhelming" : Online suicide helpline volunteers' work to manage the seriousness of help-seekers' accounts
- 2018
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Konferensbidrag (refereegranskat)abstract
- The paper presents initial analysis from a recently started project on suicide helpline communication. Preventive measures for reducing suicide are currently developed at many levels in Sweden, primarily related to biological, environmental, and social causes of suicide. Because suicide, unlike for example illness, involves primarily voluntary actions, it is difficult to predict. Prevention cannot adequately address the problem without knowledge of how individuals interpret suicide as a meaningful solution to life problems. However, updated empirically based knowledge of how suicidal persons in interaction with others interpret their situation is scarce. Foundational ethnomethodological and conversation analytic work in relation to suicide has shown the utility of examining how suicide is made meaningful in interaction, but this research is largely focused on how the suicidal person justifies suicide (Sacks 1967; Douglas 1967; Jacobs 1967). Because others’ responses can either slow down or speed up a suicidal process, it is important to focus on co-‐participants’ actions when suicide intention has been communicated. Research on online forum interaction has shown that suicidal persons in this setting orient to ‘being authentic’—not just using suicide threats to gain sympathy (Horne & Wiggins 2009). Drawing on this research, we use conversation analysis to study how volunteers in Sweden’s first suicide helpline manage taking help-‐seekers’ problems seriously, while not justifying suicide. Like suicide research in general, suicide helpline research is dominated by quantitative approaches based on researchers’ classifications, theoretically considered to be important. However, CA studies have shown that researchers’ categories do not necessarily coincide with how suicidal individuals understand their situation and others’ responses. Therefore, it is important to complement the current focus on official statistics and researchers’ definitions with research on how help-‐seekers and volunteers in helpline communication negotiate the meaning of suicide
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