| 1. |
- Boman, Åse, 1957-, et al.
(author)
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Fathers' encounter of support from paediatric diabetes teams : the tension between general recommendations and personal experience
- 2013
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In: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 21:3, s. 263-270
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Journal article (peer-reviewed)abstract
- The purpose of this grounded theory study was to explore and discuss how fathers involved in caring for a child with type 1 diabetes experienced support from Swedish paediatric diabetes teams (PDTs) in everyday life with their child. Eleven fathers of children with type 1 diabetes, living in Sweden and scoring high on involvement on the Parental Responsibility Questionnaire, participated. Data were collected from January 2011 to August 2011, initially through online focus group discussions in which 6 of 19 invited fathers participated. Due to high attrition, the data collection continued in eight individual interviews. A semi-structured interview guide was used, and the fathers were asked to share experiences of their PDT's support in everyday life with their child. A simultaneous and constant comparison approach to data collection and analysis allowed the core category to emerge: the tension between general recommendations and personal experience. This core category illuminates how the fathers experienced tension between managing their unique everyday life with their child and balancing this to meet their PDT's expectations with regard to blood glucose levels. The core category was supported by two categories: the tension between the fathers'and their PDT's knowledge, whereby fathers reported discrepancies between their PDT's medical knowledge and their own unique knowledge of their child; and the tension between the fathers'and their PDT's goals, whereby the fathers identified differences between the familys' and their PDT's goals. As a dimension of the core category, fathers felt trust or distrust in their PDT. We conclude that to achieve high-quality support for children with diabetes and to enhance their health and well-being, involved fathers' knowledge of their unique family situation needs to be integrated into the diabetes treatment.
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| 2. |
- Boman, Åse
(author)
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Fathers involved in children with type 1 diabetes : finding the balance between disease control and health promotion
- 2013
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Doctoral thesis (other academic/artistic)abstract
- Background:Type I diabetes is a chronic disease that places great demands on the child and family. Parental involvement has been found to be essential for disease outcome. However, fathers’ involvement has been less studied, even though high paternal involvement has been correlated with less disease impact on the family and higher quality of life among adolescents.Aim: The overall aim of the study was to explore and analyze constructions of fathers’ involvement in their child’s everyday life with type 1 diabetes from an ecological and health promotion perspective. Four specific aims were applied: 1) explore and describe discourses in health care guidelines for children with type 1 diabetes in Nordic countries, focusing on parents' positioning (I), 2) analyze how Swedish pediatric diabetes teams perceived and discussed fathers’ involvement in the care of their child with type 1 diabetes, and to discuss how the teams’ attitudes toward the fathers’ involvement developed during a focus group process (II), 3) explore and discuss how fathers involved in caring for their child with type 1 diabetes experience support from their pediatric diabetes team in everyday life with their child (III), and 4) analyze how involved fathers to children with type 1 diabetes understand their involvement in their child’s daily life and to discuss their perceptions from a health promotion perspective (IV).Material and methods: A qualitative and inductive approach was applied. Data were collected and analyzed during 2010-2012. The sample consisted of three pediatric guidelines originating from Norway, Denmark and Sweden (I), three Swedish pediatric diabetes teams (PDTs) (II), and 11 (III) and 16 (IV) fathers of children with type 1 diabetes who scored high involvement on the Parental Responsibility Questionnaire. Data were collected through repeated focus group discussions with the PDTs (II), online focus group discussions (III) and individual interviews (III, IV) with the fathers. Three analysis methods were applied: analysis of discourses (I), Constructivist Grounded Theory (II, III) and content analysis (IV).Findings: The findings illuminated the complex interaction between the pediatric guidelines, the PDTs and the fathers. Fathers highly involved in their child’s daily life experienced different levels of tension between the general recommendations and their personal experiences of living with a child with type 1 diabetes (III). The fathers regarded their involvement in their child’s diabetes care as additional to their general parenting, and a fine balance was identified between a health promotion perspective and a controlling involvement. The common denominator between the highly involved fathers was their use of parental leave (IV). The PDTs initially perceived fathers’ involvement as gendered and balanced on the mother’s agement, but as focus was set on fathers’ engagement the PDTs increased their awareness of this and started to identify and encourage their engagement II). At the macro-level, parents’ voices were diminished in Nordic pediatric diabetes guidelines in favor of an expert discourse (I).Conclusions: Fathers’ involvement concerning a child with type 1diabetes is constructed in a complex way, based on an interaction between the fathers’ perceptions of their additional involvement and the support provided by the PDTs; the PDTs’ perceptions of the fathers’ involvement; and how parents/fathers are constructed in pediatric diabetes guidelines. In order to promote the health and well-being of children with type 1 diabetes, fathers’ involvement needs to be taken into account in the pediatric guidelines as well as in clinical practice.
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| 3. |
- Boman, Åse, et al.
(author)
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Fathers of Children With Type 1 Diabetes : Perceptions of a Father's Involvement From a Health Promotion Perspective
- 2014
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In: Journal of Family Nursing. - : SAGE Publications. - 1074-8407 .- 1552-549X. ; 20:3, s. 337-354
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Journal article (peer-reviewed)abstract
- This study describes how fathers of children diagnosed with type 1 diabetes understand their involvement in their child's daily life from a health promotion perspective. Sixteen Swedish fathers of children living with type 1 diabetes were interviewed. Manifest and latent content analysis was used to identify two themes: the inner core of the father's general parental involvement and the additional involvement based on the child's diabetes. The former was underpinned by the fathers' prioritization of family life and the fathers being consciously involved in raising the child, and the latter by the fathers promoting and controlling the child's health and promoting and enabling the child's autonomy. The results highlight that the quality of the fathers' involvement is essential in the management of a child's chronic illness. It is important for pediatric diabetes health care professionals to assess the quality of fathers' involvement to promote the child's health.
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| 4. |
- Boman, Åse, 1957-, et al.
(author)
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If dad comes, we are happy - if mom fails to appear, we become desperate : A Grounded Theory study of Swedish diabetes teams perecption of fathers’ involvement in their child's everyday life
- 2011
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In: 4th International Research Seminar on SALUTOGENESIS and meeting of the IUP-GWG-SAL. ; , s. 1-12
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Conference paper (peer-reviewed)abstract
- Background: Since parental involvement is essential to the outcome of diabetes type 1 treatment in childhood and high paternal engagement in everyday life promote the child's health, it is of value to explore how professionals, the diabetes teams (DT), perceive fathers' involvement in their child with diabetes type 1.Method: The study design was Constructivist Grounded Theory and data was collected by Repeated Focus Groups discussions with three Swedish pediatric diabetes teams, between May 2010 and January 2011.Results: The core category for the diabetes teams' perception of fathers' involvement was If dad comes, we are happy – if mom fails to appear, we become desperate. The core category relied on three subcategories. Societal and cultural context where DTs perceived fathers involvement as having specific properties and specific areas of responsibility, Balancing where the DTs balanced the father's involvement against the mother's engagement and Becoming aware where the DTs raised awareness of the fathers from being a indistinct parents-unit till to identify and appreciate the father's engagement.Conclusions: Perceiving fathers as equal caregivers, and becoming aware of fathers as a health resource, could support an active health promotion perspective in pediatric diabetes care.
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| 5. |
- Boman, Åse, 1957-, et al.
(author)
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Parents' discursive resources : Analysis of discourses in Swedish, Danish and Norwegian health care guidelines for children with diabetes type 1
- 2012
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In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 26:2, s. 363-371
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Journal article (peer-reviewed)abstract
- The incidence of diabetes type 1 in children, the most common metabolic disorder in childhood, increases worldwide, with highest incidence in Scandinavia. Having diabetes means demands in everyday life, and the outcome of the child's treatment highly depends on parents' engagement and involvement. The aim of this study was to explore and describe discourses in health care guidelines for children with diabetes type 1, in Sweden, Norway and Denmark during 2007-2010, with a focus on how parents were positioned. As method a Foucauldian approach to discourse analysis was applied, and a six-stage model was used to perform the analysis. The findings shows a Medical, a Pedagogic and a Public Health discourse embedded in the hegemonic Expert discourse. The Expert discourse positioned parents as dependent on expert knowledge, as recipients of education, as valuable and responsible for their child's health through practicing medical skills. This positioning may place parents on a continuum from being deprived of their own initiatives to being invited to take an active part and could result in feelings of guilt and uncertainty, but also of security and significance. From this study we conclude that guidelines rooted in the Expert discourse may reduce opportunities for parents' voices to be heard and may overlook their knowledge. By broadening the selection of authors of the guidelines to include patients and all professionals in the team, new discourses could emerge and the parents' voice might be more prominent. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.
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| 6. |
- Boman, Åse, 1957-, et al.
(author)
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Swedish pediatric diabetes teams' perception of fathers' involvement : A Grounded Theory study
- 2013
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In: Nursing and Health Sciences. - : Wiley. - 1441-0745 .- 1442-2018. ; 15:2, s. 179-185
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Journal article (peer-reviewed)abstract
- The purpose of this study was to analyze how Swedish pediatric diabetes teams perceived and discussed fathers' involvement in the care of their child with type 1 diabetes. It also aimed to discuss how the teams' attitudes towards the fathers' involvement developed during the data collection process. The Constructivist Grounded Theory design was used and data were collected during three repeated focus group discussions with three Swedish pediatric diabetes teams. The core category of the teams' perception of fathers' involvement emerged as: If dad attends, we are happy – if mom doesn't, we become concerned. Initially the teams balanced their perception of fathers' involvement on the mother's role as the primary caregiver. In connection with the teams' directed attention on fathers, in the focus group discussions, the teams' awareness of the importance of fathers increased. As a consequence, the team members began to encourage fathers' engagement in their child's care. We conclude that by increasing the teams' awareness of fathers as a health resource, an active health promotion perspective could be implemented in pediatric diabetes care.
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| 7. |
- Carlerby, Heidi, 1967-
(author)
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Health and Social Determinants Among Boys and Girls in Sweden : Focusing on Parental Background
- 2012
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Doctoral thesis (other academic/artistic)abstract
- The majority of Swedish boys and girls have good psychosomatic health. Despite that the risk of mental health problems such as nervousness, feeling low and sleeping difficulties has increased steadily in recent decades. Moreover, previous surveys on health and well-being indicate that boys and girls of foreign extraction in Sweden are at increased risk of ill health compared to boys and girls of Swedish background. The main aim of this thesis was to analyse health and social determinants among boys and girls of foreign extraction in Sweden. The factors explored in papers I–IV include parental background, family affluence and gender and their associations with subjective health complaints, psychosomatic problems or health risk behaviours. Other included risk factors for ill health were involvement in bullying, low participation and discrimination at school. This thesis takes an intersectional perspective, with ambitions to be able to emphasize the interplay between different power relations (i.e. gender, social class and parental background). Two sets of cross-sectional data were used. Three papers were based on the Swedish part of the World Health Organization’s Health Behaviour in School-Aged Children. The sample consisted of 11,972 children (boys n = 6054; girls n = 5918) in grades five, seven and nine from the measurement years 1997/98, 2001/02 and 2005/06. The response rate varied between 85 and 90%. About one fifth of the included children were of foreign extraction. For the fourth paper regional data from Northern Sweden were used. Boys (n = 729) and girls (n = 798) in grades six to nine answered a questionnaire in 2011 and the response rate was 80%. About 14% of the included children were of foreign extraction. Statistical methods used were chi-square test, correlation analyses, logistic regression analyses, cluster analyses and test of mediating factor. The results showed that girls of foreign background were at increased risk of subjective health complaints (SHC) and boys of mixed background were at increased risk of psychosomatic problems (PSP). Increased risk of allocation to the cluster profile of multiple risk behaviour was shown in boys and girls of mixed background, in girls of foreign background and in girls of low family affluence. Increased risk of allocation to the cluster profile of inadequate tooth brushing was shown in boys and girls of foreign background and in girls of low family affluence. General risk factors for increased risk of ill health for boys and girls in Sweden were: any form of bullying involvement, low family affluence, low participation and discrimination at school, of which the latter also was a mediating factor for ill health. Living with a single parent was a risk factor for ill health among girls. The results can function as a basis for developing health promotion programmes at schools that focus on social consequences of foreign extraction, family affluence, participation as well as health risk behaviours and gender.
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| 8. |
- Engh, Lisbet, 1954-
(author)
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Skolsköterskans möjlighet att upptäcka och stödja barn som far illa eller riskerar att fara illa
- 2018
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Doctoral thesis (other academic/artistic)abstract
- Since children are a vulnerable group, the society has a special responsibility to protect them. The school nurse sees all pupils at school at regular health visits and thereby gains knowledge of their health and living conditions. The overall aim of the thesis was to develop empirical knowledge and understanding of the ability of the school nurse to detect and support children who are maltreated or at risk to be maltreated. The thesis is based on four studies. Study I was based on focus group interviews with school nurses. Data was analysed in accordance with Grounded Theory. Study II was a secondary analysis of study I and performed with Thematic Analysis. Studies III and IV were based on population data which was analysed by univariate and multivariate logistic regressions. The results showed that the school nurse has ability to detect children who are maltreated or at risk to be maltreated. However, also obstacles for detection were found such as lack of trust, avoidance, strong feelings and insufficient documentation. The obstacles were partly due to organisational shortcomings and dearth of resources affecting also internal and external collaboration. The school nurse strived for building trustful relations to pupils, to parents and to professionals. If the school nurse failed to report suspected child maltreatment to the child protection services it was because of worries that the reporting did not benefit the child. The school nurse avoided addressing child sexual abuse because of its particular sensitiveness, which affected the possibility to detect the abuse. Pupils in foster care were at higher risk of health problems, a more risky lifestyle, a lower degree of school attachment and lower school performance compared to pupils not in foster care. The results emphasize the potential of the school nurse to detect and support maltreated children through regular contacts with pupils, their confidence in the school nurse and trustful relations with other professionals.
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| 9. |
- Myhrene Steffenak, Anne Kjersti, 1955-
(author)
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Mental Distress and Psychotropic Drug Use among Young People, and Public Health Nurses` Conceptions of Their Roles
- 2014
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Doctoral thesis (other academic/artistic)abstract
- Aim: The overall aim of this thesis was to study mental distress, health and lifestyle habits, social factors and psychotropic drug use by young people, and how PHNs conceive their roles in relation to this.Methods: Quantitative and qualitative methods were used. Study I included data from the Norwegian Youth Health Study (NYHS, 11 620 participants, aged 15-16 years) (2000–2003) linked to the Norwegian Prescription Database (NorPD) (2004–2009). Study II included prescription data on psychotropic drugs among 15-16 year olds from the NorPD (2006–2010). Eight young people were interviewed and qualitative content analysis was used to analyse the data (III). Study IV included interviews with 20 Public Health Nurses (PHN), and was analysed using a phenomenographic approach.Main results: Mental distress was reported among 15.5% of the adolescents non-users of psychotropic drugs, 75% of whom were girls. In both genders reporting mental distress, incident psychotropic use was higher one to nine years, up to 27.7% among girls, as compared with the rest of the participants. In addition, health, lifestyle habits and social factors were associated with incident use (I). Psychotropic drug use increased during 2006–2010, hypnotics and melatonin accounted for most of the increase. In total, 16.4% of all incident psychotropic drug users in 2007 were still having prescriptions dispensed in 2010 (II). Young people experience both beneficial and undesired effects from psychotropic drugs. Access to professional support and follow-up was experienced as insufficient. Life with family, friends, school and work was influenced by psychotropic drug use, and they were afraid of being lonely and stigmatized (III). The PHNs conceived their roles in relation to young people as; the discovering PHNs who became aware of psychotropic drug use in the health dialogues and chose either to act or not to act in relation to this. Those PHNs who took action continued to be the cooperating PHNs who cooperated with the young people, their families, schools, and others. If cooperation was established, the supporting PHNs teach and support the young people in relation to psychotropic drug use (IV).Conclusions: Attention must be paid to poor mental health and increasing psychotropic drug use by young people. Advances in knowledge, treatment and follow-up are needed. The prevalence of mental distress among young people, with differences between the genders, as well as between socioeconomic groups, should have consequences for health promotion strategies. PHNs in Norway, working in health centres and schools, have responsibility and opportunity to identify and follow-up young people with mental health problems.
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| 10. |
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