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- Arvidsson, Hans, 1947
(author)
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After the 1995 Swedish Mental Health Care Reform- A follow-up study of a group of several mentally ill
- 2004
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Doctoral thesis (other academic/artistic)abstract
- Aims: The overall aim of this thesis was to follow up a sample of severely mentally ill persons after the 1995 Swedish mental health care reform and to assess if the observed changes were in accord with the aims of the reform. Methods: In 1995/96, 602 persons were surveyed and identified as severely mentally ill in a defined area of Sweden. In 2000/2001, 828 persons were surveyed using the same method. The surveyed persons were interviewed and their needs were assessed on both occasions. Study I involved the 378 persons surveyed on both occasions. The results of interviews and assessments of needs from the two occasions were compared. In Study II, the results of the interviews and need assessment in 1995/96 and in 2000/2001 were compared. The subset of the group surveyed in 2000/2001 that also was surveyed in 1995/96 (n=378) was compared to the group that was new in 2000/2001 (n=450). In study III the persons surveyed in 1995/96 but not in 2000/2001 (n=224) were investigated with respect to recovery. A small sample also participated in an interview particularly focusing on recovery. Study IV was a case register study, assessing the quantity of psychiatric care delivered during the period 1994-2003. Results: In general, the results were in accord with the aims of the reform. The number of met needs had increased and the number of unmet needs had decreased. Furthermore, efforts by psychiatric care and social services had increased for the target group of the reform. The objectives of the reform thus seemed to have been effectuated. There seemed to have been a change in the interpretation and application of the concept severely mentally ill between 1995/96 and 2000/2001. It appeared that the threshold for applying the concept had been lowered on the second survey. Only 14 % were considered to have recovered from being severely mentally ill between the two surveys. Conclusions: The findings were in accord with the aims of the reform. Why then is the reform commonly considered a failure in the public debate? The main argument for dubbing the reform a failure may be the fact that the severely mentally ill as a goup are still very underprivileged and that they are clearly not afforded opportunities equal to those enjoyed by society at large.
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| 3. |
- Arvidsson, Hans, 1947, et al.
(author)
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Effects of the Two-Way Communication Checklist (2-COM): A one-year cluster randomized study in a group of severely mentally ill persons
- 2014
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In: International Journal of Social Psychiatry. - : SAGE Publications. - 0020-7640 .- 1741-2854. ; 60:1, s. 95-102
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Journal article (peer-reviewed)abstract
- In a health-care service with the emphasis on improvement related to functioning and well-being, the communication process between patient and professionals is essential. There is a lack of research on this matter. Aim: The aim was to investigate, in a group of severely mentally ill persons, whether the use of a simple communication tool could influence the sense of empowerment, satisfaction with care, therapeutic alliance and unmet needs. Method: The study had a cluster randomized design. The intervention was a communication tool (2-COM) applied in two teams during one year. In a comparison group of two other teams, the treatment was as usual. At baseline, after six months, and after one year, assessments were made. Results: After one year the 2-COM groups seemed to have a larger reduction in unmet needs compared to the treatment-as-usual group. However, there were large problems with attrition in the study, and it was not possible to draw relevant conclusions. Conclusions: The methodological problems were substantial, and the study may be considered as a pilot study. In a main study the researchers ought to take control over the selection of patients on the basis of the experiences from this study.
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- Arvidsson, Hans, 1947
(author)
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Recovered or dead? A Swedish study of 321 persons surveyed as severely mentally ill in 1995/96 but not so ten years later
- 2011
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In: EPIDEMIOLOGY AND PSYCHIATRIC SCIENCES. - 2045-7960. ; 20:1, s. 55-63
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Journal article (peer-reviewed)abstract
- AIM: The aim was to follow-up a group of persons who were considered severely and persistently mentally ill (SMI) at the time of the 1995 Swedish mental health-care reform but not so ten years later. METHODS: Surveys were conducted in 1995/96 and 2006 in an area of Sweden. Of 602 persons surveyed as SMI in 1995/96, 321 were not found to be so in a similar survey in 2006. These persons were followed up concerning death rates and causes, as well as concerning recovery and present care. Comparisons between subgroups were made using the results of interviews conducted in 1995/96. RESULTS: Nineteen percent of the persons considered SMI in 1995/96 were recovered in 2006 in the sense that they no longer were considered SMI. The only variable found to predict recovery was diagnosis. Half of the persons in the sample given a diagnosis of neurosis were recovered but only 6% of those given a diagnosis of psychosis. Death rates and death causes seemed to be in line with previous research. CONCLUSIONS: Relatively few persons were considered recovered after ten years. Most persons in the sample were still in contact with care and services.
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- Sonesson, Ove, et al.
(author)
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Effectiveness of psychiatric inpatient care.
- 2013
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In: Scandinavian journal of caring sciences. - : Wiley. - 1471-6712 .- 0283-9318. ; 27:2, s. 319-326
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Journal article (peer-reviewed)abstract
- Scand J Caring Sci; 2012 Effectiveness of psychiatric inpatient care There is a growing demand for evaluating the process and outcome of mental health care. Most healthcare providers routinely collect and register data related to the process of treatment, and it is important to acquire more knowledge about how to make use of these databases. The aim of this study was to investigate the outcome of psychiatric inpatient care in relation to different clinical factors, using the Global Assessment of Functioning Scale (GAF) as a measure of outcome. Another objective was to explore the ability of routinely collected and registered data to provide valuable information about patients and their care. The studied psychiatric inpatient sample consisted of 816 care episodes with GAF ratings made both at admission and at discharge for 648 patients. Variables used in the study included GAF score at admission and at discharge, age, gender, diagnosis, length of stay and ward affiliation. The overall mean GAF change was 20.74, and the overall effect size Cohen's d 1.67, which corresponds to a large effect. The mean GAF change for women was 21.6, with an effect size of 1.80, and for men 19.4 with an effect size of 1.52. The effect size spectra including all groups of diagnoses ranged from 1.03 (substance-related disorders) to 2.33 (other mood disorders). Length of stay and ward affiliation also showed significant results concerning GAF change. Some limitations in this study could depend on the absence of randomization procedures and a control group. Another limitation concerns the insufficient control of the inpatient care interventions performed. The results support the capacity of the GAF to function as a measure of outcome in relation to different clinical factors, such as length of stay and diagnosis. Support was also found for the importance and usefulness of routinely collected and registered data.
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| 10. |
- Sonesson, Ove, et al.
(author)
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Exploring outcome and validity of the GAF in psychiatric inpatient care
- 2015
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In: European Journal of Psychological Assessment. - : Hogrefe Publishing Group. - 1015-5759 .- 2151-2426. ; 31:3, s. 195-201
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Journal article (peer-reviewed)abstract
- A small number of studies have investigated predictive factors in relation to the Global Assessment of Functioning (GAF) scale. This study aimed to explore the influence of clinical and socio-demographic factors in a psychiatric inpatient setting in relation to treatment outcome measured by the GAF. The studied psychiatric inpatient sample consisted of 816 episodes of care, with GAF ratings made at both admission and discharge. Multiple linear regressions were performed to analyze what variables predicted GAF scores at admission and at discharge. Significant predictors of GAF scores at admission were age, schizophrenia, other psychotic disorders, and no registered diagnosis. GAF scores at admission, patients’ diagnoses, and ward affiliation were able to significantly predict GAF at discharge. Specialized wards did not necessarily deliver the best treatment results in spite of their diagnostic specialization. This study provides support to the construct validity of the GAF when used as a measure of outcome.
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| 11. |
- Sonesson, Ove, et al.
(author)
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Reliability of a functioning scale (GAF) among psychiatric ward staff
- 2010
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In: Nordic Psychology. - 1901-2276. ; 62:1, s. 53-64
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Journal article (peer-reviewed)abstract
- This study investigated the reliability of the Global Assessment of Functioning Scale (GAF) when used by psychiatric staff from acute psychiatric wards. A special focus was attributed to factors predicting the reliability of the GAF. 101 raters from six acute psychiatric wards assessed six GAF-vignettes. Intraclass correlation (ICC) with a model of absolute agreement was used as the overall reliability measure. An overall ICC of 0.79 was obtained. There were no significant differences found between the different occupational groups or psychiatric wards according to reliability. None of the predictive factors in the regression model yielded a significant contribution to reliability. The present study supports prior results of a reliability coefficient to be found mainly in the good to excellent range. There is supporting evidence that GAF ratings performed by trained psychiatric ward staff comprise a satisfactory reliability. The present study adds to prior research showing no consistent results between studies according to reliability factors. Further studies focusing on factors related to reliability are needed.
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- Tidefors, Inga, 1949, et al.
(author)
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A Swedish sample of 45 adolescent males who have sexually offended: Background, individual characteristics, and offending behavior
- 2011
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In: Nordic Psychology. - : Informa UK Limited. - 1901-2276 .- 1904-0016. ; 63:4, s. 18-34
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Journal article (peer-reviewed)abstract
- This study describes the background, individual characteristics, and offending behavior of 45 adolescent males who have sexually offended. This group was also compared to adolescents from the general population. The data sources were intake assessment information and questionnaires. Family problems and neglect were common. Having separated parents and growing up in large families or foster-homes discriminated the group from the general population of Swedish adolescent males. The group scored higher than norm data regarding anger, depression, and disruptive behavior. They showed a wish to present themselves in a positive way and they were less open concerning sexuality than a comparison group. There were overall few significant differences between the target group and the comparison groups. Future studies need to explore offender sub-groups; specifically how and why problematic backgrounds affect children differently.
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| 14. |
- Tidefors, Inga, 1949, et al.
(author)
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Agreement between ratings from self-rating scales and assessments by staff concerning a group of ‘severely mentally ill’ people
- 2014
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In: Psychosis - Psychological, Social and Integrative Approaches. - : Informa UK Limited. - 1752-2439. ; 6:3, s. 231-234
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Journal article (peer-reviewed)abstract
- Previous research shows generally low agreement concerning self-rating scales and assessments by staff regarding people considered to be ‘severely mentally ill’. The aims of this study were to measure the level of agreement between patients’ self-rating and key workers’ assessments, and to explore some of the factors that influence level of agreement. The results of questionnaires from 49 severely mentally ill persons concerning needs, therapeutic alliance, and self-esteem were compared with key workers’ estimates. Agreement was found regarding the number of unmet needs. Concerning met needs, therapeutic alliance and self-esteem, no significant agreements were found, however, for met needs, therapeutic alliance or self-esteem.
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| 15. |
- Tidefors, Inga, 1949, et al.
(author)
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Agreement between ratings from self-rating scales and assessments by treatment staff concerning a group of adolescent males who have sexually offended
- 2010
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In: Journal of Sexual Aggression.
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Journal article (peer-reviewed)abstract
- Despite problems of validity, self-report measurements are used in clinical practice and research. The aim here was to compare self-ratings by adolescent males who had sexually offended with assessments of the same adolescents made by professionals. Results of two self-report questionnaires were compared with staff estimates. It was assumed that observability of behaviour, social desirability of the adolescents’ responses, intellectual difficulties and the presence of neuropsychiatric problems would affect the level of agreement between participant and professional responses. Agreement between staff estimates and self-ratings was generally low. However, some results supported the assumptions: i.e. higher levels of agreement on observable behaviour, higher levels of agreement for adolescents scoring low on social desirability and, most obviously, lower levels of agreement for boys with neuropsychiatric diagnoses. Discrepancies between what adolescents say about themselves through selfratings and how professionals perceive them cause problems in assessments that rely on self-rating measurements.
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| 17. |
- Tidefors, Inga, 1949, et al.
(author)
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Narratives about consensual and non-consensual sexuality told by male adolescents who have sexually offended
- 2010
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In: 32nd Annual meeting and conference of the nordic association for clinical sexology, birth death sexuality.
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Conference paper (peer-reviewed)abstract
- Few studies focus on what adolescents who have sexually offended, themselves say about sexuality. Interview-transcripts from forty-five adolescent males who had sexually offended were analyzed by a thematic analysis. The narratives were interpreted from a perspective of attachment and coping. Sexual memories from childhood concerned unclear limits and experiences of sexual abuse. During adolescence, there was a lack of pleasant sexual memories, knowledge, and discussion-partners. Sexuality was mainly described as unimportant. There is a need for more knowledge about the role of sexuality in sexual offences and how to make ways for allowed sexuality to be strengthened.
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