| 1. |
- Hamreby, Kerstin, 1950-
(författare)
-
Flickor och pojkar i den sociala barnavården : Föreställningar om kön och sociala problem under 1900-talet
- 2004
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The topic of this study is girls and boys in the field of child welfare. The aim has been to trace and describe conceptions of gender, delinquency and social problems in child welfare from the end of the nineteenth century until the middle of the twentieth century. The sources of data in the study consist of legislative documents, journals and other historical literature representing the professional discourse. Two analytical approaches have been used. First, the sources were employed for descriptions of legislation and the legislative processes in child welfare. Second, the material was analyzed with a discursive approach to elucidate conceptions of gender and their importance in the legislative process and thus in the construction of social problems. Three main periods with different currants of ideas have been identified. In the first period moralism dominated. Thoughts about social problems were based in normative assumptions and scientific influences were rare. Child welfare legislation was deeply influenced by ideas of social control. Young people were to be controlled and disciplined especially through work: Girls through household work and care and boys through paid work. In the second period hygienism, ideas based in hygiene discourses, were the main trend. Genetically based arguments together with discussions about morality and poverty were used to explain social problems, and scientific methods were to be used to discipline and control young people. Proposals for measures take against social problems corresponded to two main lines, a hygienic-medical line and a social pedagogic line. The hygienic-medical line had a considerable influence on actions taken to prevent and deal with social problems. One example was the compulsory care and sterilization of certain young women to prevent them from reproducing. The social pedagogic line comprised parents’ education, the role of the family and sexual education. An increased use of psychological explanations for experiences and behaviour among individuals and groups was seen in the 1930’s; this marked the beginning of the third period, psychologism. During the period of psychologism, science, mainly represented by psychology and psychiatry, gradually achieved a greater impact in those processes where young people were categorized as social problems. If in the previous period external discipline was the means of control, in this period internalized self-discipline was to be the means of adjustment. The study showed that conceptions of girls and boys in child welfare were gendered throughout the first half of the twentieth century. This bias has had an impact on how girls and boys were treated in child welfare services. Discussions about social problems concerning girls were often about sexuality and sexual actions, and discussions concerning boys were about violence and criminality. Social problems among girls were seen above all as moral transgressions and social problems among boys as juridical transgressions. These differing conceptions are of great importance when considering how girls and boys were judged and treated according to the child welfare Acts in existence during the first part of the twentieth century.
|
|
| 2. |
- Bergström, Gunnar, Professor, et al.
(författare)
-
Long-term, non-specific spinal pain: reliable and valid subgroups of patients
- 2001
-
Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 39:1, s. 75-87
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to identify reliable and valid subgroups of spinal pain patients, using data from the Swedish version of the Multidimensional Pain Inventory (MPI-S). A second aim was to test the generalisability of the three patient profiles described in earlier studies on the MPI (”adaptive coper”, ”dysfunctional” and ”interpersonally distressed” patients). The study base consisted of two samples of individuals suffering from long-term, non-specific spinal pain and the results were validated across these samples. Cluster analysis was used to detect distinct groups of patients and the validity of these subgroups was evaluated on variables not used to generate the cluster solution. One subgroup was characterised by lower pain severity, lower interference with everyday activities, lower affective distress and higher life control than the other two subgroups. This patient profile was similar to the MPI adaptive coper patients. A second subgroup resembled the dysfunctional patient profile, thus displaying a worse adjustment to chronic pain than the AC patients. The third patient group reported significantly lower levels of social support from “significant others” than the other subgroups. This patient profile was similar to that of the interpersonally distressed patient group. Taken together, the results support the reliability, validity and generalisability of three subgroups of chronic pain patients derived from the MPI-S.
|
|
| 3. |
- Bergström, Gunnar, Professor, et al.
(författare)
-
The impact of psychologically different patient groups on outcome after a vocational rehabilitation program for long-term spinal pain patients
- 2001
-
Ingår i: Pain. - : LWW. - 0304-3959 .- 1872-6623. ; 93:3, s. 229-237
-
Tidskriftsartikel (refereegranskat)abstract
- A better knowledge of differential treatment outcomes for subgroups of chronic spinal pain patients may, for instance, help clinicians in treatment planning or pain researchers in treatment outcome research. The purpose of this prospective study was to evaluate the predictive validity of a subgroup classification based on the Swedish version of the (West Haven Yale) Multidimensional Pain Inventory, the MPI-S. Patients referred to a vocational rehabilitation program were classified into one of three groups, labeled ‘adaptive copers’, ‘dysfunctional’ patients, and ‘interpersonally distressed’ patients, and followed over an 18-month follow-up period. The outcome variables were absence from work (defined as sick listing plus early retirement), general health status, and utilization of health care resources. To our knowledge, the predictive validity of the MPI subgroups has not been evaluated regarding sick listing and early retirement after rehabilitation. As hypothesized, the results showed that the ‘dysfunctional’ patient group had significantly more registered absences from work and reported higher utilization of health care, over the follow-up period compared to the ‘adaptive copers’. Furthermore, as hypothesized, the ‘interpersonally distressed’ and ‘dysfunctional’ patient groups report a poorer general health status than the ‘adaptive copers’ over the whole follow-up period. However, contrary to our hypothesis, the proportion of improved patients did not differ significantly between the subgroups. Altogether, the predictive validity of the MPI-S subgroup classification was mainly confirmed. The clinical implications of this study suggest that the matching of treatment to patient needs may enhance treatment outcome, reduce pain and suffering among chronic spinal pain patients and facilitate a better health economic allocation of treatment resources.
|
|
| 4. |
- Jensen, Irene B., et al.
(författare)
-
A randomized controlled component analysis of a behavioral medicine rehabilitation program for chronic spinal pain: are the effects dependent on gender?
- 2001
-
Ingår i: Pain. - : LWW. - 0304-3959 .- 1872-6623. ; 91:1, s. 65-78
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to evaluate the outcome of a behavioral medicine (BM) rehabilitation program and the outcome of its two main components, compared to a ‘treatment-as-usual’ control group (CG). The study employed a 4×4 repeated-measures design with four groups and four assessment periods (pre-treatment, post-treatment, 6-month follow-up, and 18-month follow-up). The group studied consisted of subjects on sick leave identified in a nationwide health insurance scheme in Sweden. After inclusion, the subjects were randomized to one of four conditions, which were: (1) behavior-oriented physical therapy (PT); (2) cognitive behavioral therapy (CBT); (3) BM rehabilitation consisting of PT+CBT (BM); (4) a ‘treatment-as-usual’ CG. The treatments were given over a period of 4 weeks, PT and CBT on a part-time basis and BM on a full-time basis. Outcome variables were sick leave, early retirement, and health-related quality of life (measured using the Short Form Health Survey, SF-36). The results showed that the risk of being granted full-time early retirement was significantly lower for females in PT and CBT compared to the CG during the 18-month follow-up period. However, the total absence from work (sick listing plus early retirement) in days over the 18-month follow-up period was not significantly different in the CG compared to the treatments. On the SF-36, women in CBT and BM reported a significantly better health-related quality of life than women in the CG at the 18-month follow-up. No significant differences for men were found on the SF-36 scales. In conclusion, the results revealed gender differences in the outcome of the treatments and that the components of this BM program yielded as good results as the whole program.
|
|
| 5. |
- Jensen, Irene B., et al.
(författare)
-
Assessing the Needs of Patients in Pain: A Matter of Opinion?
- 2000
-
Ingår i: Spine. - : LWW. - 0362-2436 .- 1528-1159. ; 25:21, s. 2816-2823
-
Tidskriftsartikel (refereegranskat)abstract
- Study Design. A prospective cohort study including patients with nonspecific spinal pain was performed.Objectives. To investigate whether the use of expert judgment in routine practice can provide a basis for reliable decision making concerning the need for intervention in patients with spinal pain and their ability to benefit from treatment.Summary of Background Data. A wide range of instruments and techniques are used to assess and treat patients with spinal pain. Many instruments are used without being clinimetrically tested.Methods. A questionnaire concerning the patients’ need of treatment and their potential to assimilate it was sent to experts in the health care arena: physicians, physical therapists, social insurance officers. The experts included were those connected with patients participating in a larger outcome study. Two cohorts of patients (sample 1, n = 217; sample 2, n = 257) were followed for 6 and 12 months, during which time the patients’ health and work status were mapped.Results. No acceptable agreement was found between any of the experts’ ratings of patients’ needs and potential for rehabilitation. Logistic regression showed that the experts’ judgments were based almost solely on the age of the patient. The prediction analyses showed that the most consistent predictor of the patients’ status at the 6-month follow-up assessment was the patients’ own belief in the existence of effective treatments and their perceived ability for learning to cope with the condition.Conclusions. Expert judgment as exercised in routine practice cannot be used as basis for reliable decision making concerning the need of the patient with spinal pain for intervention and the patient’s ability to benefit from treatment.
|
|
