| 1. |
- Gottvall, Maria, 1980-, et al.
(author)
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Mental health and societal challenges among forced migrants of diverse sexual orientations, gender identities and gender expressions : health professionals’ descriptions and interpretations
- 2024
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In: Culture, Health and Sexuality. - : Taylor & Francis. - 1369-1058 .- 1464-5351.
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Journal article (peer-reviewed)abstract
- The aim of this study was to explore health professionals’ descriptions and interpretations of post-migration mental health and societal challenges among forced migrants with diverse sexual orientations, gender identities and gender expressions. Participants representing seven professions were recruited by a combination of convenience, purposive and snowball sampling. Data were collected through focus groups and individual interviews, analysed with systematic text condensation in a collaborative process involving researchers, clinicians and migrants with lived experiences. Participants described a challenging trajectory for migrants, as migrants venture through an uncertain and demanding journey impacting their mental health. Needing to deal with legal requirements, stressful circumstances and normative expectations during the asylum process were highlighted as major challenges, along with exposure to discrimination, violence, abuse and lack of psychosocial safety. Participants described significant psychological distress among migrants, including loneliness and shame. Challenges were also recognised related to exploring, accepting and expressing sexuality and gender. Loneliness and shame are major challenges in need of further attention in research, which could be addressed through the development and evaluation of actions, programmes and interventions to provide peer support.
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| 2. |
- Gottvall, Maria, 1980-, et al.
(author)
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Nurse education about forced migrants with diverse sexual orientations, gender identities, and gender expressions : An exploratory focus group study
- 2023
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In: Nurse Education Today. - : Elsevier. - 0260-6917 .- 1532-2793. ; 128, s. 105880-
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Journal article (peer-reviewed)abstract
- BACKGROUND: In many countries, forced migrants can seek asylum based on persecution and danger related to self-identifying as having diverse sexual orientations, gender identities, and gender expressions; herein defined as lesbian, gay, bisexual, transgender, queer, or other non-heterosexual orientations, non-cisgender identities, gender expressions and/or reproductive development considered beyond cultural, societal or physiological norms. Nurse education has a significant role in promoting cultural competence among future health professionals.OBJECTIVES: To explore the experiences and views regarding education about forced migrants with diverse sexual orientations, gender identities, and gender expressions, among students and lecturers in nurse education.DESIGN: Explorative qualitative study with focus group discussions.SETTINGS: Swedish nursing programs.PARTICIPANTS: Final-year nursing students and lecturers (n = 25 participants) at nursing programs were recruited with convenience and snowball sampling.METHODS: Semi-structured digital focus group discussions (n = 9) were audio recorded and transcribed verbatim. Data were analyzed with inductive qualitative content analysis.RESULTS: Promoting a broader understanding regarding societal structures and preparing students to provide culturally sensitive care were considered as essential components in nurse education. Challenges and problems involved a need for increased awareness, the associated topics and target populations seldom being addressed, and a need for improvements within clinical placements. Participants suggested the utilization of external resources, presented a range of different specific learning activities that would promote in-depth understanding, and articulated a need for overarching decisions and guidelines regarding mandatory inclusion in nurse education.CONCLUSIONS: Students and lecturers describe several challenges and problems that need to be addressed in regard to forced migration, sexual health, and inclusion health. There seems to be a need for utilization of external competence in learning activities as well as establishing clearer guidelines, which may increase the quality of education and better prepare future nurses to support patients with diverse backgrounds and identities.
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| 3. |
- Gottvall, Maria, 1980-, et al.
(author)
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Post‐migration psychosocial experiences and challenges amongst LGBTQ + forced migrants : A meta‐synthesis of qualitative reports
- 2023
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In: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 79:1, s. 358-371
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Journal article (peer-reviewed)abstract
- Aims: Synthesize qualitative research to illuminate the post-migration psychosocial experiences amongst LGBTQ+ forced migrants.Design: Meta-synthesis of qualitative reports.Data sources: Systematic searches in seven databases and manual screenings were performed in July 2021 (21,049 entries screened in total). The final sample included 29 English-language reports containing empirical qualitative findings about post-migration experiences and published 10 years prior to the searches, based on migrants as the primary source.Review Methods: Methodological quality was appraised using the CASP and JBI checklists. Through a collaborative process involving nurse-midwife researchers and experienced clinical professionals, reports were analysed with a two-stage qualitative meta-synthesis including an inductive qualitative content analysis.Results: The methodological quality was high and the reports included 636 participants in total. Two themes were identified through the meta-synthesis. The first theme illustrates the psychological distress and numerous challenges and stressors forced migrants face after arrival, including challenges encountered as an LGBTQ+ forced migrant, psychological reactions and manifestations, and practical issues related to resettlement and living conditions. The second theme highlights the resilience and strength they find through various internal processes and external resources, including resilience and strengthening resources, identity formation and establishing and maintaining social relationships.Conclusion: After arrival in the host country, forced migrants identifying as LGBTQ+ face numerous societal and personal challenges whilst being at risk of experiencing significant psychological distress. These migrants utilize a wide range of resources that may strengthen their resilience. Peer support stands out as a highly appreciated and promising resource that needs further attention in experimental research.Impact: Forced migrants identifying as LGBTQ+ need access to adequate and sufficient support. The findings emphasize several strength-building resources that may inform nurses, midwives, researchers and other professionals when providing psychosocial support for these persons.Patient or Public Contribution: No patient or public contribution.
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| 4. |
- Mattebo, Magdalena, 1976-, et al.
(author)
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School Nurses' Perceptions and Experiences of Delivering a School-Based Intervention to Improve Primary Prevention of Human Papillomavirus Among Adolescents-A Focus Group Study Following a Randomized Controlled Trial
- 2024
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In: Journal of School Nursing. - : SAGE PUBLICATIONS INC. - 1059-8405 .- 1546-8364.
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Journal article (peer-reviewed)abstract
- The present qualitative study is a part of the process evaluation of a complex intervention, the randomized controlled trial, "Prevention of human papillomavirus (HPV) in a school-based setting." We aimed to explore participating school nurses' perceptions and experiences of delivering the educational HPV intervention to adolescents aged 16. Focus group interviews were conducted with school nurses (n = 20) and analyzed with inductive qualitative content analysis. The overall theme Easily adapted into the existing role as a school nurse permeated the participants' views. The nurses were in favor of delivering an intervention that increased the HPV vaccination rates and improved beliefs and awareness about HPV prevention. It suits their work and health-promoting aspect of their role well and can easily be adapted into the current school health consultant curriculum. Having material in different languages to share with adolescents and their parents to promote equal health was deemed important.
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| 5. |
- Carlsson, Tommy, et al.
(author)
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Desiring support on a winding road with challenging intersections : Social and professional support for sexual minority forced migrant men
- 2024
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In: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648.
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Journal article (peer-reviewed)abstract
- AimTo explore experiences of social and health professional support among sexual minority forced migrant men.DesignExploratory qualitative study.MethodsIndividual semi-structured interviews were conducted in 2023 with 15 participants recruited through convenience, purposive and snowball sampling. Interviews were audio recorded, transcribed and analysed with systematic text condensation in a collaborative process between researchers and experts by lived experience.ResultsThe first category was 'desiring support along a road with challenging intersections'. Participants encountered a harsh reality and dangers in the host country. They sought social connections and communicated with others whilst in a social labyrinth within a new and reserved society. Although social support was desired and highly appreciated, the process involved a spectrum of both belonging and exclusion. The second category was 'navigating uncharted waters when seeking affirming health services'. A range of barriers to health services were encountered in a complex health system. Participants emphasized the importance of safe and affirming spaces that accommodate the vulnerability of disclosure.ConclusionEnsuring respectful and affirming support for sexual minority forced migrants is essential. Barriers in accessing health services need to be addressed, including informing about rights and ensuring safety.Implication for the Professional and Patient CareNurses and other health professionals can consider social support as a potentially valuable resource for health promotion. However, there is a need for more research investigating its mental health effects.ImpactThe intersectional disadvantages and discrimination encountered by sexual minority forced migrants call attention to the need for further advancements in inclusion health and affirming care.Reporting MethodThis study adhered to the Consolidated Criteria for Reporting Qualitative Research.Patient or Public ContributionThree sexual minority forced migrants were members of the research team. They were involved in the data collection, analysis and reporting in close collaboration with researchers.
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| 6. |
- Gottvall, Maria, 1980-, et al.
(author)
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Challenges and opportunities of a new HPV immunization program : Perceptions among swedish school nurses
- 2011
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In: Vaccine. - : Elsevier BV. - 0264-410X .- 1873-2518. ; 29, s. 4576-4583
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Journal article (peer-reviewed)abstract
- Aim To investigate school nurses’ perceptions of HPV immunization, and their task of administering the vaccine in a planned school-based program in Sweden. Method: Data were collected through five focus group interviews with school nurses (n = 30). The interviews were recorded, transcribed verbatim and analyzed using content analysis.Findings The theme Positive attitude to HPV immunization despite many identified problems and challenges summarizes the results. The school nurses saw the program as a benefit in that the free school-based HPV immunization program could balance out social inequalities. However, they questioned whether this new immunization program should be given priority given their already tight schedule. Some also expressed doubts regarding the effect of the vaccine. It was seen as challenging to obtain informed consent as well as to provide information regarding the vaccine. The nurses were unsure of whether boys and their parents should also be informed about the immunization.Conclusion Although some positive aspects of the new HPV immunization program were mentioned, the school nurses primarily identified problems and challenges; e.g. regarding priority setting, informed consent, culture and gender. In order to achieve a good work environment for the school nurses, and obtain a high coverage rate for the HPV immunization, these issues need to be taken seriously, be discussed and acted upon.
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| 7. |
- Gottvall, Maria, 1980-, et al.
(author)
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Health-related quality of life among Syrian refugees resettled in Sweden
- 2020
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In: Quality of Life Research. - : Springer. - 0962-9343 .- 1573-2649. ; 29:2, s. 505-514
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Journal article (peer-reviewed)abstract
- Purpose The main purpose of this study was to assess health-related quality of life (HRQoL) among Syrian refugees resettled in Sweden. Further, we wanted to investigate whether sex, age, education, area of residence, cohabitation and social support were associated with HRQoL in this population. Methods This is a cross-sectional study including 1215 Syrian refugees from a randomly selected sample frame resettled in Sweden between the years 2011 and 2013. HRQoL was measured by the EQ-5D-5L descriptive system, and EQ-5D-5L index values were calculated. Associations between sex, age, education, area of residence, cohabitation, social support and EQ-5D-5L were investigated using multiple linear regression analysis. Results Depression/anxiety was the most commonly (61.9%) reported EQ-5D-5L problem among the group of Syrian refugees. The mean EQ-5D-5L index value was found to be 0.754. Male sex, younger age, cohabitation and social support were found associated with a higher EQ-5D-5L index score. Conclusions Our results concerning long-lasting health problems among the study population indicate that there is a profound need for policies and interventions promoting refugees' health. Our results also show that social support, a modifiable factor, is relevant to refugees' overall health, pointing to the importance of public health interventions and policies targeting the facilitation, mobilization and enhancing of refugees' social support.
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| 8. |
- Gottvall, Maria, 1980-, et al.
(author)
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Including a discussion forum in a web-based intervention on fertility and sexuality following cancer - Usage and content
- 2022
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In: Internet interventions. - : Elsevier. - 2214-7829. ; 29
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Journal article (peer-reviewed)abstract
- Aim: The aim of the study was to investigate how young adult survivors of childhood cancer used an online discussion forum as part of a web-based psycho-educational intervention. Specifically, we aimed to characterize users of the discussion forum, investigate how they used the discussion forum (type of usage) and content of the posted messages.Methods: This study is a part of a randomized controlled trial, Fex-Can Childhood RCT. Participants with self-reported sexual dysfunction or fertility-related distress were drawn from a population-based national cohort. Sociodemographic and clinical characteristics of the intervention group (n = 322) and data on usage of the discussion forum were analysed with descriptive statistics and compared between subgroups. Messages posted in the online discussion forum were analysed with qualitative thematic analysis.Results: Approximately half (48 %) of participants in the intervention group accessed the discussion forum and most of them (76 %) without writing own posts. Users of the discussion forum did not statistically differ in sociodemographic or clinical characteristics from the rest of the intervention group. The 97 written posts, written by 38 individuals, were mainly descriptions of own experiences and thoughts and concerned three themes: A changed body, Concerns around family building and Longing for support. Peer-support and interaction between participants were seen in some forum threads and the 'like'-function was frequently used, demonstrating engagement and activity. Participants expressed that they felt affinity with and appreciated sharing own experiences and to recognize themselves in others' stories.Conclusions: A discussion forum as part of a web-based intervention appears to be a valuable component by giving participants an opportunity to share intimate experiences and concerns related to surviving cancer.
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| 9. |
- Gottvall, Maria, 1980-
(author)
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Introduction of School-Based HPV Vaccination in Sweden : Knowledge and Attitudes among Youth, Parents, and Staff
- 2014
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Doctoral thesis (other academic/artistic)abstract
- The overall aim of this thesis is to provide a better understanding of knowledge, attitudes, consent, and decision-making regarding Human papillomavirus (HPV) vaccination, seen from the perspectives of concerned parties – high school students, school nurses, and parents.Two quantitative studies were performed: one descriptive cross-sectional study and one quasi-experimental intervention study. Qualitative studies using focus group interviews and individual interviews were also performed.High school students’ knowledge about HPV and HPV prevention was low but their attitudes toward HPV vaccination were positive. An educational intervention significantly increased the students’ knowledge regarding HPV and HPV prevention. Their already positive attitudes toward condom use and HPV vaccination remained unchanged. The students wanted to receive more information about HPV from school nurses. The school nurses were also positive to HPV vaccination but identified many challenges concerning e.g. priorities, obtaining informed consent, culture, and gender. They saw an ethical dilemma in conflicting values such as the child’s right to self-determination, the parents’ right to make autonomous choices on behalf of their children, and the nurse’s obligation to promote health. They were also unsure of how, what, and to whom information about HPV should be given. Parents, who had consented to vaccination of their young daughters, reasoned as follows: A vaccine recommended by the authorities is likely to be safe and effective, and the parents were willing to do what they could to decrease the risk of a serious disease for their daughter. Fear of unknown adverse events was overweighed by the benefits of vaccination. Parents also saw the school nurse as an important source of HPV information.Conclusions: Positive attitudes toward HPV vaccination despite limited knowledge about HPV, are overarching themes in this thesis. School nurses have a crucial role to inform about HPV prevention. It is important that the concerned parties are adequately informed about HPV and its preventive methods, so that they can make an informed decision about vaccination. A short school-based intervention can increase knowledge about HPV among students. From a public health perspective, high vaccination coverage is important as it can lead to a reduced number of HPV-related disease cases.
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| 10. |
- Gottvall, Maria, 1980-, et al.
(author)
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Knowledge of human papillomavirus among high school students can be increased by an educational intervention
- 2010
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In: International Journal of STD and AIDS (London). - : SAGE Publications. - 0956-4624 .- 1758-1052. ; 21:8, s. 558-562
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Journal article (peer-reviewed)abstract
- The aim of this study was to evaluate the effect of an educational intervention concerning human papillomavirus (HPV) directed at Swedish first year high school students. The intervention consisted of a class room lesson, a website and a folder. Outcome variables were knowledge of HPV and attitudes to preventive methods such as HPV vaccination, condom use and Pap smear testing. An intervention group (n = 92) was matched with two comparison groups (n = 184). At baseline, the median score for HPV knowledge was one out of 10 in both groups. At follow-up, the median knowledge score had increased to six in the intervention group, but was still one in the comparison group (P < 0.001). Attitudes to HPV vaccination, condom use and Pap smear testing remained the same (P > 0.05). In conclusion, a short school-based intervention can greatly increase the students' knowledge about HPV, but attitudes and behaviours are less easy to influence.
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