| 1. |
- Andersson, Catrine, et al.
(författare)
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Using Twelve-Step Treatment for Sex Addiction and Compulsive Sexual Behaviour (Disorder) : A Systematic Review of the Literature
- 2024
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Ingår i: Sexual Health & Compulsivity. - : Routledge. - 2692-9953.
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study is to explore the current scientific evidence for using the twelve-step method as a treatment method for sex addiction and compulsive sexual behavior (disorder). Peer-reviewed empirical articles on the twelve-step method and sex addiction and compulsive sexual behavior (disorder) written in English, Danish, Norwegian, or Swedish, retrievable in selected databases were included. No limits were set on publication date or study design. The systematic review resulted in eight empirical studies which were read and assessed according to the Mixed Methods Appraisal Tool. The results were inconclusive, and we found only three articles of high quality, where the samples were composed mainly by men, which indicate that peer-therapy in combination with individual therapy might be beneficial. That twelve-step treatment rests heavily on the idea of sex addiction was unproblematized in most of the publications. Overall, the findings raise issues concerning who benefits from this treatment.
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| 2. |
- Arvidsson, Anna, 1971-, et al.
(författare)
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School health-care team members’ reflections of their promotion of sexualand reproductive health and rights (SRHR) : Important but neglected
- 2024
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier. - 1877-5756 .- 1877-5764. ; 39
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Young people are prioritized regarding the promotion and safeguarding of sexual and reproductivehealth and rights – SRHR. In Sweden, the school is seen as an important arena with members of the school healthcare or SHC team as vital actors in this work. This study explored SRHR-related work in SHC teams in Sweden.Methods: Within an explorative qualitative design, structured interviews were conducted with 33 nurses, counsellors, SHC unit managers and headmasters. Reflexive thematic analysis was applied, and two main themesfound.Results: SHC team members see SRHR as an urgent topic, but address it only ‘when necessary’, not systematically– and they experience a shortage of guidance and cooperation regarding SRHR-related work. Even in a countrywith agreement on the importance of SRHR for all and on providing holistic comprehensive sex education inschools, young people are left to chance – i.e., to the SRHR competence in the professionals they meet.Conclusion: SHC team members in Sweden see SRHR as an urgent topic but do not address it systematically.Moreover, they experience a shortage of guidance for their work. To avoid any professional stress of conscienceand for equitable school health care regarding SRHR to be realized, research-informed policy needs to underlinesystematic, comparable and proactive practice.
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| 3. |
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| 4. |
- Björklund, Frida, et al.
(författare)
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“It’s easier to think outside the box when you are already outside the box” : A study of transgender and non-binary people’s sexual well-being
- 2024
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Ingår i: Sexualities. - : Sage Publications. - 1363-4607 .- 1461-7382. ; 27:3, s. 495-512
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Tidskriftsartikel (refereegranskat)abstract
- With a phenomenological approach, we explored transgender and non-binary people’s strategies to experience sexual well-being. Ten self-reports (seven interviews and three written texts) were analyzed, and the analysis resulted in six themes. The first three (Affirming oneself, Having access to care, and Being respected as one’s gender) were strategies for sexual well-being realized through affirming one’s identity, receiving the gender-confirming care wanted, and having one’s gender identity respected by others. The other three themes (Masturbating and fantasizing, Communicating and being open, and Being sexually free in queer spaces) were strategies for one aspect of sexual well-being—pleasure. The results describe strategies that all can learn from: the need to accept and appreciate oneself, not just adapt to gender norms of bodies and behaviors, and to communicate. In addition, it illuminates that being norm-breaking, or stepping out of the gendered paths presented to you, appears to provide new opportunities for people to learn what they enjoy, and this could lead to a broader repertoire of pleasurable sexual practices—practices that take bodily prerequisites into account
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| 5. |
- Carlström, Charlotta, lektor, et al.
(författare)
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LGBTQ plus Affirmative State Care for Young People in Sweden : New Knowledge and Old Traditions
- 2023
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Ingår i: British Journal of Social Work. - : Oxford University Press. - 0045-3102 .- 1468-263X. ; 53:8, s. 3744-3760
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Tidskriftsartikel (refereegranskat)abstract
- Young LGBTQ+ people are over-represented in various forms of state care. They experience hardships during their placements and staff competence in addressing specific needs among LGBTQ+ youth is lacking. In this article, we investigate whether and how LGTBQ+ issues are considered and described in digital marketing for state care providers. The material consists of the homepages of residential care homes and secure state care institutions, which we analyse using critical discourse analysis. The results show that LGBTQ+ issues are largely invisible. Of the approximately 1,000 existing state care providers, only twenty stated that they worked with or had competence in LGBTQ+ issues. Among these, no secure state care institution offered LGBTQ+ competence at the time of the study. The descriptions of how care providers work with LGBTQ+ issues are characterised by heteronormativity where there is a mix of two types of language on the homepages regarding LGBTQ+ youth; on the one hand, a heteronormative, traditional description based on a binary understanding of gender; and, on the other, an LGBTQ+ inclusive language is used. However, the LGBTQ+ affirmative language has been imposed upon the traditional rather than being integrated into it, which comes across as superficial and unclear. International studies show that LGBTQ+ youth are over-represented in various forms of state care. Using critical discourse analysis, we investigated how LGBTQ+ youth, as a target group, are described and how LGBTQ+ competence is presented on the home pages of residential care homes and secure state care institutions for young people in Sweden. The results show that LGBTQ is largely invisible. Of the approximately 1,000 existing residential care homes, only 20 stated that they worked with or had competence in LGBTQ+ issues. No secure state care institution offered LGBTQ+ competence at the time of the study.
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| 6. |
- Hammarström, Sofia, 1984-, et al.
(författare)
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Ask me, listen to me, treat me well and I shall tell: a qualitative study of Swedish youths’ experiences of systematic assessment of sexual health and risk-taking (SEXIT)
- 2022
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Ingår i: Sexual and Reproductive Health Matters. - : Informa UK Limited. - 2641-0397. ; 30:1
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Tidskriftsartikel (refereegranskat)abstract
- Sexual ill health among young people, in terms of sexually transmitted infections (STIs), unintended pregnancy, transactional sex and sexual violence, is a global public health concern. To that end, the SEXual health Identification Tool (SEXIT) was developed. The purpose of this study was to explore the visitors’ experiences of a youth clinic visit when SEXIT was used. A purposively selected sample of 20 participants (16–24 years of age) was recruited from three Swedish youth clinics using SEXIT. Participants were interviewed individually in March and April 2016, and data were analysed using inductive qualitative content analysis. The analysis resulted in four main categories describing the participants’ experiences of using SEXIT: “Issues of concern” includes descriptions of the items in SEXIT as important; “Enabling disclosure” describes how SEXIT serves as an invitation to talk and facilitates disclosure of negative experiences; “Road to change” captures experiences of the conversation with the healthcare professional; and “Managing power imbalance” describes experiences regarding the response and attitudes of the healthcare professional as well as the participants’ fears of being judged. The categories are connected by the overarching theme “Ask me, listen to me, treat me well and I shall tell”. This study contributes knowledge on young people’s experiences of a tool-supported dialogue on sexual health and risk-taking initiated by the healthcare professional. Structured questions in a written format, as a basis for dialogue, are appreciated and experienced as a functioning way of addressing sexual ill health and risk-taking at Swedish youth clinics.
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| 7. |
- Hammarström, Sofia, 1984-
(författare)
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Identification of young people at risk of sexual ill health : implementing a new tool in youth clinics
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Young people are at increased risk of sexual ill health in terms of sexually transmitted infections, unintended pregnancy, and sexual violence. There is limited knowledge of evidence-based preventive practices for identification of young people at risk of sexual ill health when in contact with health care. Aims: The overall aim of this thesis was to generate new knowledge concerning how Swedish youth clinics can work systematically to identify young people at risk of sexual ill health or who have negative sexual experiences. Specific objectives were to develop a risk-assessment model for the identification of youth at risk of contracting chlamydia; to develop and pilot-implement an evidence-informed tool for identifying young people at risk of sexual ill health in terms of sexually transmitted infections, unintended pregnancies, and sexual violence at Swedish youth clinics; and to explore youth clinic visitors’ and staff’s experiences of using that tool. Methods: The thesis takes a mixed methods approach and includes four studies. First, data from a national sample of sexually active young people, aged 15–24 years (n=6544), were used to develop a risk-assessment model for chlamydia infection. Second, a risk-assessment tool (SEXual health Identification Tool; SEXIT) was developed and pilot-implemented at three youth clinics for 1 month. The tool includes three components: (1) staff training; (2) a questionnaire for youth clinic visitors; and (3) a written guide for staff to support the subsequent dialogue and risk assessment based on the questionnaire. Questionnaire data from visitors (n=268) and staff (n=18) were analysed. Third, youth clinic visitors’ experiences were explored in 20 interviews with visitors (15–24 years) from the participating youth clinics. Fourth, staff’s experiences of working with SEXIT were investigated in four focus group discussions (n=16). Quantitative and qualitative methods were used for data analyses. Results: The risk-assessment model demonstrated that the distribution of chlamydia is skewed; 38% of cases were estimated to occur among a tenth of the population. Women most at risk of chlamydia were best identified using the variables age, number of sexual partners in the past year, and experience of sex for reimbursement. The corresponding variables for men were age, number of sexual partners, and alcohol use. SEXIT was validated and pilot-implemented at three youth clinics (response rate 86%). Before implementation, all staff perceived a need for more systematic screening for sexual risk-taking and sexual ill health at youth clinics. Youth clinic visitors demonstrated between 0 and 7 parallel risk factors. Staff experienced that using SEXIT systematically increased the consistency and quality of the clinics’ work, and youth clinic visitors reported that the questions were important and not uncomfortable or difficult. The visitors explained that questions in a written format followed by a dialogue initiated by the youth clinic staff enabled disclosure of negative experiences. Conclusions: The risk-assessment model demonstrates that the number of partners during the past year is the most important risk factor for chlamydia regardless of gender. SEXIT is an acceptable, appropriate, and feasible tool from the perspective of youth clinic staff, youth clinic visitors, and from an implementation point of view. Using the tool systematically may help raise important questions on sexual risk-taking and sexual ill health with youth clinic visitors and identify visitors with multiple risk factors. Being asked the sensitive yet important questions in SEXIT, followed by a respectful and non-judgemental conversation led by the youth clinic staff, has the potential to open up a more in depth and broader dialogue about the visitors’ sexual health. The systematic procedure helps youths feel that they are taken seriously and instils a feeling of trust that enables disclosure of sensitive experiences. From the staff perspective, SEXIT facilitates identification of young people exposed to or at risk of sexual ill health by simplifying and ensuring consistency and quality in their work.
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| 8. |
- Hammarström, Sofia, 1984-, et al.
(författare)
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Staff´s experinces of the SEXual health Identification Tool (SEXIT)
- 2022
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Ingår i: ESC Abstract Book 2022. - : European Society of Contraception and Reproductive Health. ; , s. 88-89
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundIn 2016 SEXIT, an evidence-informed the toolkit, was developed and pilot-implemented at three Swedish youth clinics. Swedish youth clinics are highly accessible and focused primarily on concerns related to sexual and reproductive health and mental health among young persons aged 13-25 years. The SEXual health Identification Tool (SEXIT) was developed to facilitate identification of young people exposed to, or at risk of, sexual ill health in terms of sexually transmitted infections, unintended pregnancy, transactional sex, or sexual violence. The tool includes three components; (1) staff training, (2) a questionnaire for visitors, and (3) a written guide for staff to support the dialogue and risk assessment. Previous results demonstrated promising results; a high response rate from visitors (86%), few missing answers, and youth clinic visitors reporting factors associated with sexual ill health. Interviews demonstrated that youth clinic visitors appreciated structured questions in a written format as a basis for dialogue and found SEXIT appropriate for addressing sensitive topics. ObjectivesTo explore the youth clinic staff’s experiences of using SEXIT systematically with all visitors, with a focus on usefulness, implementation determinants, and feasibility of implementing SEXIT at Swedish youth clinics.MethodFour focus group discussions with youth clinic staff who participated in the pilot implementation. The clinics had used SEXIT systematically with all visitors for one month. Data were analysed using qualitative analysis designed for focus groups.ResultsMost participants experienced that the SEXIT routines were well functioning and that using SEXIT gave a comprehensive picture of the visitor and resulted in more concrete answers, which facilitated the risk assessment. Youth clinic staff experienced that SEXIT advanced their knowledge and the midwifes experienced that they identified more youth at risk with SEXIT, while the psychosocial staff were less convinced on how SEXIT best should be applied. Existing challenges related to the routines at the clinics and heavy workload during drop-in hours. Further, the staff were concerned about the continued care of vulnerable, and hard-to-reach youth clinic visitors that sometimes do not attend the scheduled revisits.Conclusions Staff experience SEXIT as useful for identifying young people exposed to or at risk of sexual ill health. Systematic use ensures consistency and quality in assessing the visitors, which may facilitate implementation. The use of SEXIT is challenged by heavy workload, conflicting routines, and the experience that some visitors identified through SEXIT decline further care. Implementation of SEXIT in Swedish youth clinics is considered feasible.
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| 9. |
- Hammarström, Sofia, 1984-, et al.
(författare)
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Staff's experiences of a pilot implementation of the SEXual health Identification Tool for assessing sexual ill health among visitors to Swedish youth clinics: A focus group study
- 2021
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Ingår i: Sexual and Reproductive Healthcare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 29
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Tidskriftsartikel (refereegranskat)abstract
- Background: Young people are disproportionally burdened by sexual ill health. The SEXual health Identification Tool (SEXIT) was developed for use at youth clinics, to facilitate identification of visitors exposed to or at risk of sexual ill health. The aim of this study was to explore experiences of using SEXIT among youth clinic staff who participated in a pilot implementation, with a focus on usefulness, implementation determinants, and feasibility of implementing SEXIT at Swedish youth clinics. Methods: Four focus group discussions were conducted with youth clinic staff from three clinics. The clinics had used SEXIT systematically in consultations with all visitors for one month. Data were analysed using qualitative analysis designed for focus groups. Results: Most participants experienced that the SEXIT routines were well functioning and that using SEXIT gave a comprehensive picture of the visitor and resulted in more concrete answers, which facilitated the risk assessment. The medical staff experienced that they identified more youth at risk with SEXIT, while the psychosocial staff were less convinced. Existing challenges related to the routines at the clinics and heavy workload during drop-in hours. Conclusions: Staff experience SEXIT as useful for identifying young people exposed to or at risk of sexual ill health. Systematic use ensures consistency and quality in assessing the visitors, which may facilitate implementation. The use of SEXIT is challenged by heavy workload, conflicting routines, and the experience that some visitors identified through SEXIT decline further care. Implementation of SEXIT in Swedish youth clinics is considered feasible. © 2021
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| 10. |
- Hammelev Jörgensen, Susanna, et al.
(författare)
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The Vicious Cycle of Magical Thinking : How IT Governance Counteracts Digital Transformation
- 2023
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Ingår i: Electronic Government. - : Springer. - 9783031411380 - 9783031411373 ; , s. 381-396
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Konferensbidrag (refereegranskat)abstract
- Digital transformation is associated with a fundamental change in the operating models of organizations and industries alike. At the same time, previous research highlights that existing governance practices may act as a deterrent to digital transformation. In this study, we explore how the IT governance of a large university counteracts necessary digital transformation in higher education over time. We show how the adoption of an industry-standard IT governance framework, through a series of generative mechanisms, leads to a vicious cycle that restricts digital transformation into mere computerization, thereby successfully counteracting digital transformation. In other words, the IT governance framework increasingly protects the organization from the organizational change brought on by new digital opportunities. This is discussed in relation to the literature on IT governance and digital transformation with the intent of contributing with a critical perspective on the widespread adoption and use of standard IT governance framework.
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| 11. |
- Hjalmarsson, Emma, et al.
(författare)
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"To live until you die could actually include being intimate and having sex" : a focus group study on nurses' experiences of their work with sexuality in palliative care
- 2020
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 29:15-16, s. 2979-2990
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of the study was to examine nurses' experiences of working with issues of sexuality in palliative care.BACKGROUND: Sexuality has value for human lives and relations and is important for one's overall well-being throughout life. Guidelines for palliative care state that sexuality should be addressed. Previous research shows that the inclusion of sexuality in general healthcare is deficient, and there is a knowledge gap on how sexuality is addressed in palliative care.METHOD: Within a qualitative design, the empirical material was obtained through three focus group interviews with eleven registered nurses working in palliative care. The interviews were analyzed using qualitative content analysis.RESULT: Nurses experience that sexuality has an indistinct place in their work, 'sexuality' is a word difficult to use, and differing views are held on whether it is relevant to address sexuality, and if so, when? Although they have experiences involving patient and partner sexuality, which is viewed as sexuality in transformation during the palliative care process, nurses seldom explicitly address patient or partner sexuality. Despite the lack of knowledge, routines and organizational support, they acknowledge the importance of addressing sexuality in palliative care, as they express that they want to do right.CONCLUSION: Overall, nurses appear to follow differing cultural, interpersonal and intrapsychic scripts on sexuality rather than knowledge-based guidelines. This underlines the importance of managers who safeguard the adherence to existing palliative care guidelines where sexuality is already included. In this work, it is important to be aware of norms to avoid excluding patients and partners that differ from the nurses themselves as well as from societal norms on sexuality.RELEVANCE TO CLINICAL PRACTICE: The results can be used as a point of departure when implementing existing or new guidelines to include and address sexuality and sexual health needs in palliative care.
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| 12. |
- Kristina, Areskoug-Josefsson, et al.
(författare)
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Exploring the role of sexual attitude reassessment and restructuring (SAR) in current sexology education : for whom, how and why?
- 2022
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Ingår i: Sex Education. - : Taylor & Francis. - 1468-1811 .- 1472-0825. ; 22:6, s. 723-740
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Tidskriftsartikel (refereegranskat)abstract
- As concerns about sexual and reproductive health and rights become integrated into public health policies, the demand for higher education in sexology rises. There is a need therefore to evaluate established pedagogical methods to ensure that they are relevant, efficient and lead to valuable competencies. This study explored the current evidence and pedagogical relevance for Sexual Attitude Reassessment and restructuring (SAR) as part of professional higher education in sexology. A systematic review was conducted with eleven included publications. Data were synthesised across studies and presented narratively. The publications were generally old and derive from a small pool of researchers geographically centred to the USA. Several studies were based on small numbers of participants, display a great variety in types of participants, use different evaluation instruments (mostly unvalidated), and a variety of methods to measure the results of SAR. Furthermore, long-term follow-up has been rare. Extensive, high-quality, and up-to-date research for SAR as an effective pedagogical method for use in sexology higher education for professionals today is lacking. Digital solutions focusing on broadening students sexological self-awareness appear more feasible than SAR, and suitable pedagogical and digital solutions need to be developed and evaluated to ensure high-quality teaching of sexology in higher education.
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| 13. |
- Larsdotter, Suzann, et al.
(författare)
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Educator and staff perspectives on a rights-based sex education for young men in jail and prison in Sweden
- 2022
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Ingår i: Sex Education. - : Taylor & Francis. - 1468-1811 .- 1472-0825. ; 23:1, s. 114-127
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Tidskriftsartikel (refereegranskat)abstract
- Young men in jail and prison are vulnerable regarding sexual health and the fulfilment of their sexual rights. As a response to this, the Swedish Association for Sexuality Education (RFSU) has been providing sex education to young, incarcerated men, via a project initiated by and in cooperation with the Swedish Prison and Probation Services (SPPS). This article is a qualitative exploration of how RFSU educators experienced their work, and of how staff within SPPS experienced the initiative. Eight RFSU educators, and six persons working within SPPS were interviewed, and a thematic analysis was conducted. Overall, the experiences described by RFSU educators and by SPPS staff were similar, they regarded sex education sensitive to what young men wanted to discuss as valuable and the project feasible. Future improvement areas include strategies on how to handle toxic masculinity among young men in jail and prison. Additionally his, the different aims that the organisations RFSU and SPPS have, and how young men navigate them, must be acknowledged. Young men’s voices are missing in this study, and examining their experiences of the sex education in future work would be valuable.
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| 14. |
- Lindroth, Malin
(författare)
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On the Outskirts of the Charmed Circle : Challenges and Limitations of Sexual Health Promotion to Young People in Secure State Care
- 2021
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Ingår i: Sexuality Research & Social Policy. - : Springer. - 1868-9884 .- 1553-6610. ; 18, s. 87-96
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Young people on the verge of, or in, secure state care or incarceration have reduced general and sexual health. The promoting of sexual health among young people in secure state care is therefore a responsibility for both the state-run agency responsible for this care and for the professionals who work there. Methods This position paper discusses sexual and reproductive health and rights (SRHR) for young people in secure state care in Sweden. Four previous studies on sexual health of young people in secure state care are revisited, and governmental policy documents are examined. Results Young people in secure state care face many threats to their sexual and reproductive health and rights. Some of these threats originate with the institutional placement itself and the lack of knowledge among the staff. Clashes on various levels between the subjectively desired (young people seeking pleasure from sex, alcohol, or other drugs) and the societally desired (sexual health, minimal alcohol use, and no drug use among young people) are described. In addition, clashes are seen between young people who want to be like everyone else in their social context and the staff with a mission (i.e. job description) to readjust young people into adopting socially accepted behaviour. Conclusion I argue that young people in secure state care have sexual experiences that are marginalized and placed on the outskirts of the charmed (sexual) circle of societally accepted sexual behaviour. In addition, their experiences are surrounded by silence, a silence sustained by both young people and professionals. The readiness of professionals to handle SRHR for young people in secure state care in a knowledge-based and non-judgemental fashion is crucial. Future research should focus on this readiness and have the needs and wishes of young people as its departing point. Although the article involves a local context, it may be of interest to a wider audience, as the placement of young people in secure state care and other forms of incarceration occurs worldwide.
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| 15. |
- Lindroth, Malin, et al.
(författare)
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SGBA and the social determinants of health : Public health, human rights and incarcerated youth
- 2021. - 1
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Ingår i: Sex and gender-based analysis in public health. - Switzerland : Springer. - 9783030719289 - 9783030719296 ; , s. 139-148
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- In this chapter, we focus on a sex- and gender-based analysis (SGBA) concerning young people incarcerated in state institutions in Sweden. We identify and discuss specific areas concerning sexual and reproductive health and rights (SRHR) wherein normative assumptions affect incarcerated young people’s sexual health and their access to sexual health services.Governments and related public health agencies must ensure, on both policy and practice levels, that inequalities in access to sexual health care and related sexual health outcomes for incarcerated young people are addressed. In Sweden, policies exist, including the use of a sex- and gender-based analysis, but clear action on the practice level is lacking. The national Public Health Agency has addressed young people in secure state care as a group in need of interventions, but in light of the analysis made, we see several challenges that need to be addressed: (1) the lack of SRHR competence in staff, (2) the organization of sexual and reproductive health care being unclear and risking the accessibility for incarcerated youth, and (3) the organization of secure state care builds on gender-stereotypical, heteronormative, and cis-normative ideas of youth sexualities and identities, which risks emphasizing existing vulnerabilities. This is evident both in the case of gender-separated wards and in the implicit ideas of youth sexualities and identities that organize the care. In conclusion, public health at all levels has a key role to play in working concretely to address the sex- and gender-based challenges to sexual health outcomes of youth in secure care.
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| 16. |
- Lindroth, Malin, 1968-, et al.
(författare)
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Social Workers as Allies? Gender Confirming Practices and Institutional Limitations in Youth Residential Homes
- 2024
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Ingår i: Clinical social work journal. - : Springer Science+Business Media B.V.. - 0091-1674 .- 1573-3343.
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Tidskriftsartikel (refereegranskat)abstract
- Previous research shows that LGBTQ+ youth are over-represented in out-of-home care and that especially transgender andnon-binary youth face challenges during their placement. These challenges stem from, among other factors, the lack ofknowledge and competence of professionals regarding the unique needs of transgender and non-binary youth. In Sweden,there are policies that aim to protect transgender and non-binary youth from discrimination and to promote their sexualand reproductive health and rights, and an increasing number of residential homes claim to have LGBTQ competencewhen competing for placements. However, it is unclear how this affects the everyday experiences of trans and non-binaryyouth at residential homes. The purpose of this study is to investigate the practices and challenges of clinical social workers at residential care homes when working with gender identity and sexual health issues among young transgender andnon-binary youth. Eight semi-structured interviews focusing on professionals’ knowledge and experiences were conductedand analysed using reflexive thematic analysis. Four themes emerged: i) Knowledge being a personal matter; ii) Heteronormativity and binarity creating consequences; iii) Handling discrimination and harassments; and iv) Creating a trustfulalliance. The results show that knowledge is a personal matter, and social work professionals seek the knowledge theyneed instead of receiving it in education or training. The contextual heteronormativity and binarity creating consequencesat the residential care home pose challenges for social workers and they have to find creative ways to support transgenderand non-binary youth and address the harassments and discrimination that these youth face. Moreover, the social workersshare their strategies regarding how they are creating a trustful alliance. Overall, they identify significant challenges todeveloping clinical social work that is affirming of transgender and non-binary youth.
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| 17. |
- Magnusson, Emilie, et al.
(författare)
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'We try' - how nurses work with patient participation in forensic psychiatric care
- 2020
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 34:3, s. 690-697
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Tidskriftsartikel (refereegranskat)abstract
- RationalePatients in secure forensic psychiatric care have reduced autonomy because of the constraints imposed on them by compulsion laws. Thus, it is vital that nurses enable patient participation whenever possible. Patient participation, and it′s clinical use in forensic psychiatric care, is an understudied field.AimTo describe nurses’ experiences of their work with patient participation in forensic psychiatric care.MethodsManagers at different secure forensic psychiatric institutions in the south of Sweden approved the study, and oral consent was retrieved from informants. Interviews guided by a semi‐structured interview guide were conducted with nine nurses from five different forensic psychiatric institutions and analysed with content analysis.FindingsNurses describe diverse understandings and abilities in an inflexible setting. This indicates that what participation is, and how to achieve it, is not the same for nurses as for patients. Moreover, patients have different abilities to participate, and the secure setting in itself is perceived as hindering participatory work. Still, participation is described as a crucial part of work that requires a caring relationship. Furthermore, nurses pronounce potentially excluding attitudes and strategies that may obstruct patient participation for all, and at the same time, they have a belief that improvement is possible.ConclusionCompulsory forensic psychiatric care is a complex care context that requires constant efforts from nurses to balance patients’ rights and needs with mandatory care. The very nature of this caring context appears to be a major obstacle when promoting patient participation. Nevertheless, nurses express that they do aim for patient participation, ‘they try’. From a patient's perspective, trying is not sufficient and a need for improvement is evident. The results can be of clinical interest in similar secure forensic psychiatric nursing settings, and a point of departure in future development of care striving for increased patient participation for all.
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| 18. |
- Schindele, Anna ChuChu, et al.
(författare)
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Analysing intersecting social resources in young people’s ability to suggest safer sex - results from a national population-based survey in Sweden
- 2022
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Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundSafer sex is one of the most crucial areas in sexual and reproductive health and rights (SRHR). Drawingon the theory of health promotion where social life generates resources for health our hypothesis is that having controlover one’s life situation, affects the ability for safer sex and thereby sexual health. The aim is to explore the associationbetween having control over one’s life and the ability to suggest safer sex among young people aged 16–29, andhow this plays out in relation to membership of six constructed social groups based on: gender, transgender experience,sexual identity, economy, being foreign-born, and social welfare recipiency followed by an in-depth analysis ofthe intersection of gender and sexual identity.MethodsThe data set comprises cross-sectional survey responses from a stratified random sample of 7755 in thetotal Swedish population of young people. The SRHR-focused questionnaire was developed within the HIV-monitoringprogram at the Public Health Agency of Sweden. Data collection was conducted by Statistics Sweden betweenApril 15 and June 8 in 2015. The survey had a response rate of 26%, which was in line with the study design. Statisticalanalysis was used to explore the self-reported outcome variable ability for safer sex and the exposure variable controlover one’s life. The methods used comprise multivariate logistic regression and an intersecting multivariate regressionexploring 12 intersecting social positions by gender and sexual identity.ResultsThe results show that young people’s control over their lives is associated with their ability for safer sex. Dueto this, control over one’s life can be seen as a resource for safer sex. The associations in the 12 intersecting social positionsshowed complex patterns.Conclusions: The intersections of resources show the complexity and that gender cannot account for all differencesin the resources for young people’s ability to suggest safer sex. Implications for policy and practitioners involve bothaddressing and strengthening the sexual rights of young people from sexual minorities and tailoring interventions ina way that takes the intersections between gender and sexual identity into consideration.
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| 19. |
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| 20. |
- Schindele, Anna ChuChu, et al.
(författare)
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Perceived knowledge gained from school-based sexuality education : results from a national population-based survey among young people in Sweden
- 2023
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Ingår i: Sexual Health. - : CSIRO Publishing. - 1448-5028 .- 1449-8987. ; 20:6, s. 566-576
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundSchool-based sexuality education is a core component of securing young people’s right to attain health equity regarding sexual and reproductive health and rights. This paper aims to explore how perceived knowledge (sufficient or insufficient) of taking care of one’s sexual health is associated with knowledge gained from school-based sexuality education and social determinants.MethodsThe data material is drawn from a population-based survey conducted in Sweden in 2015. The survey had 7755 respondents and a response rate of 26%. To explore the aim descriptive statistics and logistic regression models were used.ResultsOur results show that perceived insufficient knowledge from school-based sexuality education was associated with higher odds of reporting not being able to take care of one’s sexual health. The highest significant excess risk for insufficient knowledge was found among young people from sexual minorities.ConclusionsYoung people in Sweden do not have equal abilities to receive knowledge needed to take care of their sexual health and thus attain sexual health literacy. There is an unequal distribution of perceived knowledge, and LGBTQI+ youth particularly face barriers in using school-based sexuality education as a resource for sexual health literacy.
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| 21. |
- Schindele, Anna ChuChu, et al.
(författare)
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Sexual and reproductive health and rights (SRHR) among young people in secure state care and their non-incarcerated peers : a qualitative, descriptive and comparative study
- 2021
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Ingår i: European Journal of Social Work. - : Routledge. - 1369-1457 .- 1468-2664. ; 24:4, s. 657-670
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Tidskriftsartikel (refereegranskat)abstract
- Young people in secure state care have impaired general as well as sexual health. Social work practice that addresses SRHR among young people in secure state care is thus called for. Using a qualitative design, this descriptive and comparative paper combines the results of two separate surveys on sexual health with young people 16-29 years old. 7755 young women and men in Sweden and 117 young women and men in secure state care in Sweden participated. The results show large differences in sexual health between the groups. Young women in secure state care are the most vulnerable. Implications for social work are discussed, and a SRHR-affirmative perspective is suggested. This SRHR-affirmative practice is particularly important when social work involving young people is organised in a compulsory fashion.
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| 22. |
- Schindele, Anna ChuChu
(författare)
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Vulnerabilities and Resources : Exploring intersecting conditions for health equity in sexual and reproductive health and rights(SRHR) among young people in Sweden
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- SVENSK SAMMANFATTNINGBAKGRUND: Sexuell och reproduktiv hälsa och rättigheter (SRHR) är en central bestämningsfaktor för hälsa och utgör en viktig del av livet i övergången från barndom till vuxen ålder. Den nationella SRHR-policyn i Sverige strävar mot jämlika förutsättningar för hälsa. I Sverige idag är sexuellt överförbara infektioner (STI) vanliga, vilket tyder på att det behöver ske en beteendeförändring där fler unga har säkrare sex. Resultat från tidigare forskning visar att en del grupper av unga är mer sårbara än andra och har mer erfarenheter av osäkert sex, sex mot sin vilja och sex mot ersättning. Vidare visar tidigare studier att unga inom följande sociala grupper: HBTQI+-personer, utrikesfödda unga, och unga med sämre socioekonomiska tillgångar, har sämre sexuell hälsa. Tidigare studier har inte utforskat hur jämlika förutsättningar har betydelse för hälsa i intersektionerna inom och mellan dessa sociala grupper. Lite är också känt om hur resurser som kan skapa mer jämlika förutsättningar i hälsa fördelas, sett ur ett intersektionellt perspektiv. SYFTE: Det övergripande syftet med denna avhandling är att utforska förutsättningarna för jämlik hälsa inom området sexuell och reproduktiv hälsa och rättigheter (SRHR) bland unga i åldern 16-29 år i Sverige. Mer specifikt analyseras intersektioner av sociala bestämningsfaktorer som skapar sårbarheter eller resurser i relation till SRHR. Detta övergripande syfte utforskas i fyra artiklar som berör sex olika SRHR-relaterade områden. Oskyddat sex, sex mot sin vilja och sex mot ersättning analyseras genom begreppet sårbarhet. Säkrare sex, sexuell hälsolitteracitet och nöjdhet med sexlivet analyseras genom begreppet resurser. METOD: Det empiriska materialet är hämtat från den stratifierade och randomiserade nationella befolkningsundersökningen ”Sexualitet och hälsa bland unga i Sverige” även kallad ”UngKAB15”. Undersökningen bygger på ett slumpmässigt urval av 29 950 ungdomar som drogs från Totalbefolkningsregistret och besvarades av 7 755 respondenter vilket gav en svarsfrekvens på 26 procent. De statistiska metoderna som använts i avhandlingen är deskriptiv statistik samt regressionsmodeller. RESULTAT: I artikel I presenteras ett deskriptivt intersektionellt schema som ger en visuell förståelse för hur en intersektionell analys kan identifiera utsatta positioner i relation till SRHR. Schemat visar exempelvis att intersektionen av sexuell identitet och kön spelar roll för vem som är sårbar för sex mot sin vilja. Resultaten visar att det finns ett behov av att både nationella och globala befolkningsbaserade undersökningar åtföljs av en intersektionell analys för att identifiera sårbara grupper i behov av SRHR-insatser. Artikel II visar på ett samband mellan unga människors kontroll över sin livssituation och förmåga att föreslå säkrare sex. Att känna kontroll över livet kan alltså definieras som en resurs för möjligheten att ha säkrare sex. Den intersektionella analysen visar på komplexiteten av hur kön och sexuell identitet påverkar säkrare sex då exempelvis unga killar med homo- och bisexuell identitet är mer resursstarka än heterosexuella killar. Kön kan inte ensamt förklara alla skillnader som finns i ungas resurser för säkrare sex. Artikel III visar ett samband mellan otillräcklig kunskap från skolbaserad undervisning i sexualitet, samtycke och relationer inom fem utforskade kunskapsområden (kroppen, sexuellt överförda infektioner, sexualitet, relationer och jämställdhet samt normer och hbt-perspektiv), och högre odds för att inte kunna ta hand om sin sexuella hälsa. Gruppen med högst överrisk för otillräcklig kunskap, och därmed sämre tillgång till hälsofrämjande resurser, återfinns bland unga HBTQI+-personer. Resultaten från artikel IV visar ett samband mellan att vara nöjd med sitt nuvarande sexliv och god hälsa. Nöjdhet med nuvarande sexliv är alltså en potentiell resurs för god hälsa. Denna resurs är dock ojämnt fördelad, eftersom killar och icke-binära unga är mindre nöjda med sitt sexliv än tjejer. SLUTSATS: Avhandlingen bidrar med fördjupad kunskap om hur intersektionalitet utgör ett användbart verktyg för att utforska förutsättningar till jämlik hälsa inom SRHR-området bland unga i åldern 16-29 år. Den intersektionella analysen har bidragit till att belysa ”grupper inom grupperna” och synliggöra mer eller mindre sårbara eller resursstarka positioner inom de hälsoutfallsområden som har utforskats. Användningen av intersektionell analys har underlättat identifieringen av en rad komplexa mönster och tydliggjort sårbarheter och resurser inom SRHR-området bland unga i Sverige. IMPLIKATIONER OCH FRAMTIDA FORSKNING: När intersektionalitet används som ett analytiskt verktyg påvisas ett komplext mönster av sårbarheter och resurser i SRHR-relaterade hälsoutfall. Det intersektionella perspektivet belyser att kön behöver analyseras tillsammans med andra sociala bestämningsfaktorer för att förstå komplexiteten i sårbarheter och resurser för hälsa. Sammantaget pekar resultaten på att global och nationell policy inom SRHR-området behöver uppdateras med kunskaper om intersektionalitet. Intersektionalitetsperspektivet behövs för att utveckla metoder för att hantera och inkludera små undersökningsgrupper, och därigenom, exempelvis, undvika att reproducera den binära könsnormen som baseras på kvinnor och män. Framtida forskning med intersektionell metod kan belysa den mångfald som finns i en befolkning och öka kunskapen om olika ”grupper inom gruppen”. Därmed stärks möjligheten att genom jämlika förutsättningar till hälsa nå det globala målet om ett hållbart och inkluderande samhälle i enlighet med Agenda 2030.
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| 23. |
- Schindele, Anna ChuChu, et al.
(författare)
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Vulnerability Analysis in Sexual and Reproductive Health and Rights (SRHR) : Indications of Intersecting Vulnerable Positions in a NationalSurvey Among Young People in Sweden
- 2022
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Ingår i: Sexuality Research & Social Policy. - : Springer Nature. - 1868-9884 .- 1553-6610. ; 19, s. 1034-1045
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionSexual and reproductive health and rights (SRHR) policies use gender as the foremost social determinant toexplain vulnerability in relation to SRHR among young people. Therefore, our aim was to explore intersecting vulnerablepositions within the three SRHR-related outcome areas: unsafe sex, sex against one’s will, and transactional sex, amongyoung people aged 16–29.MethodsThe data set is from a randomised, cross-sectional, and population-based SRHR survey conducted in Swedenin 2015, and the 7755 respondents imply a response rate (26%) in line with the power estimations. How gender intersectswith fve other social positions, i.e. social determinants (sexual identity, transgender experience, perceived economy, beingforeign-born, and social welfare recipiency), was explored through a stepwise descriptive intersecting vulnerability analysisexemplifed through three outcome variables: unsafe sex, sex against one’s will, and transactional sex.ResultsGender intersects with other social determinants and creates vulnerable positions in SRHR-related outcomes. Themost vulnerable positions within each of the three outcome variables were the following: (1) for unsafe sex: being a manand homosexual; (2) for sex against one’s will: being a woman and bisexual; and (3) for transactional sex: being a man andhaving transgender experience.Conclusions Despite limitations, the descriptive intersecting vulnerability analysis indicates how gender intersects withother social determinants and generates multiple vulnerable positions in relation to SRHR.Policy ImplicationsThe results can be of interest in future studies on vulnerability and inform policies that intend to fulflthe intention of leaving no one behind, as stated in the Agenda 2030.
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| 24. |
- Schindele, Anna ChuChu, et al.
(författare)
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Vulnerability Analysis in Sexual and Reproductive Health and Rights (SRHR) : Indications of Intersecting Vulnerable Positions in a NationalSurvey Among Young People in Sweden
- 2022
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundThe UN policies on global sexual and reproductive health and rights (SRHR) use gender as the foremost social determinant to explain vulnerability in relation to SRHR among young people. The Agenda 2030 explains SRHR only in relation to girls and women. Can we find new ways to analyse and discuss vulnerability and resources in SRHR. Our hypothesis is that intersectionality might be a useful tool. AimThe aim is as to explore intersecting vulnerable positions within the three SRHR related outcome areas; unsafe sex, sex against one’s will and transactional sex , among young people aged 16 29, through the development of a stepwise descriptive intersecting vulnerability analysis. MethodsThree outcome variables from the survey: 1. unsafe sex,2. sex against one’s will3. transactional sex Cross tabulations of outcome variables (1-3) stratified by gender andthe intersection of five other social determinants:1. gender*sexual identity2. gender*transgender experience3. gender*economy4. gender*foreign born5. gender*social welfare recipiency ResultsThe descriptive intersecting vulnerability analysis visualise how gender intersects with five other social determinants and how this generates vulnerable positions within the three outcome areas: unsafe sex, sex against one’s will and transactional sex. Vulnerable positions are complex and different in most of the three outcome areas. Intersectionality is a useful tool for vulnerability analysis in SRHR.
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