| 1. |
- Eklund, Rakel, 1986-, et al.
(author)
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The self-help app My Grief : Bereaved parents' experiences of helpfulness, satisfaction and usability
- 2024
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In: Internet Interventions. - : Elsevier. - 2214-7829. ; 35
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Journal article (peer-reviewed)abstract
- Mobile health (mHealth) apps have been shown to be useful to monitor and reduce mental health problems across a variety of stress-related and affective disorders, yet research on the value of apps for prolonged grief is scarce. Therefore, the main aim of this study was to elucidate bereaved parents' experiences of using the self-help app My Grief with a focus on helpfulness, satisfaction, and usability. Data were derived from closed-ended and open-ended questions administered at the 3-month post-assessment of the intervention group (n = 67) within a randomized controlled trial testing the effects of access to the My Grief app. The sample consisted of 88 % women, with a mean age of 47 years, who predominantly lost their child to cancer (41 %), on average 4.8 years ago. Participating parents indicated that the My Grief app helped them increase their knowledge about prolonged grief and track their grief over time. The app was experienced as easy to navigate and around half of the parents used the app more than one day a week. Almost all parents were satisfied with the app and would recommend it to other parents in similar situations. The findings add to the knowledge base justifying mHealth within support systems for bereaved adults.
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| 2. |
- Englund, Liselotte, 1964-, et al.
(author)
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Media perception and trust among disaster survivors : Tsunami survivors' interaction with journalists, media exposure, and associations with trust in media and authorities
- 2022
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In: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 10
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Journal article (peer-reviewed)abstract
- A critical part of disaster communication is media coverage in the interface of the afflicted, media, and authorities. One communication key is building trust. Disaster survivors encounter journalists in a high-stress context, but little is known about their perceptions of these interactions and the subsequent media exposure. The aim of this study is to explore how survivors 6 years after a major disaster perceived their encounters with journalists and exposure in the media, as well as their level of trust in the media, compared with government and authorities. Data were used from a longitudinal study of Swedish tourists, repatriated from the 2004 Indian Ocean tsunami, surveyed up to 6 years after the tsunami to assess posttraumatic stress (PTS) and effects on mental health. At 6 years after, the survey included questions about survivors' perceptions of journalist interactions (reported by n = 311), of their own media exposure (n = 177), and survivors' trust in media organizations and public authorities (n = 1,181). Tsunami survivors mainly perceived interactions with journalists as being professional. There were 14% who reported that the interactions were supportive and 17% that the interactions were a strain. Similarly, most participants had a neutral view concerning the subsequent media coverage or exposure, although 12% experienced media exposure as stressful and 12% reported that it had been involuntary. Finally, the survivors indicated higher confidence and trust in Swedish radio and TV as compared to the Swedish authorities, and the participants' level of trust in the media was associated with their perceptions of journalists, r = 0.34, p < 0.001, and media coverage, r = 0.47, p < 0.001. Disaster survivors mainly agreed with emotionally neutral statements about interacting with the media, the performance of journalists on site, and their own media exposure. Nonetheless, a substantial minority found the encounters and exposure to be negative, and the results suggest a link between personal experiences or perceptions and trust in the media.
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| 3. |
- Englund, Liselotte, 1964-, et al.
(author)
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Reporting under extreme conditions : journalists' experience of disaster coverage
- 2023
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In: Frontiers in Communication. - : Frontiers Media S.A.. - 2297-900X. ; 8
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Journal article (peer-reviewed)abstract
- Introduction: Media presence on site and reports on disasters are crucial parts of disaster communication. Aside from authorities, civil society, concerned businesses and citizens, the media constitute an important actor. The working conditions, situational competence and management among journalists on duty in a disaster area are important factors within the complex area of crisis management and disaster communication. This study aims to explore the working conditions, challenges, and coping strategies among journalists covering the Haiti earthquake in 2010.Methods: Ten months after the event, Scandinavian journalists (n = 32) provided free-text responses about their work on site through a web survey. The free- text responses underwent content analysis. In addition, self-report questionnaires were used to assess general mental health and posttraumatic stress.Results: We found that journalists faced five main challenges in Haiti: situational (technicalities, practical, collegial), professional (mission, approach, roles), personal (traits, emotions, coping), traumatic (general mental health and posttraumatic stress) and experiential (learning and growth). They described a difficult and challenging mission, but also an eye-opening and life-changing experience. Most respondents' questionnaire responses indicated low risk for both poor mental health and posttraumatic stress, with a few significant exceptions. Being properly equipped and mentally prepared, getting collegial support and maintaining professional focus were seen as important, and good leadership and clear instructions from editors at home were highlighted.Discussion: Corroboration of the present findings would strengthen our knowledge of their experiences, and may provide valuable insights for designing preparedness activities in the future as well as for applying to other communication functions in disasters.
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| 4. |
- Gustavsson, Martina E, et al.
(author)
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Moral stress among Swedish health care workers during the COVID-19 pandemic : a cross-sectional study
- 2023
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In: Scandinavian Journal of Work and Organizational Psychology. - Stockholm : Karolinska Institutet, Dept of Global Public Health. - 2002-2867.
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Journal article (peer-reviewed)abstract
- Aims: This study quantifies to what extent Health care workers (HCWs) experienced moral stress and to what extent their experiences of moral stress were related to gender and age as well as to working directly with COVID-19 patients and other work-related factors. Methods: This study consists of a cross-sectional survey that was conducted among 16,044 Swedish HCWs. A total of 153,300 HCWs and support staff who participated in the COVID-19 training offered by the Karolinska Institute were invited by email to participate in a web survey during autumn 2020. Results: This study is the first to quantify the frequency and severity of moral stress in a large group of HCWs. Moral stress was reported to a higher extent by HCWs involved in COVID-19 care and those involved in direct patient care. A lack of resources and the restrictions that hindered the patients’ family and friends from being involved were major causes of moral stress. Informal support was reported as being the most available and useful for dealing with moral stress. Conclusions: Our findings suggest that moral stress is common among HCWs who work with infected patients during a pandemic. The goal should not be to eliminate moral stress, as such stress may be viewed as a normal reaction to moral issues, but organizational structures (sufficient staffing and resources), could decrease the likelihood of morally stressful situations. Finally, to avoid the development of moral distress and its potential consequences, improvements could be made in providing HCWs with support tools for managing moral stress.
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| 5. |
- Halvorsen, Peter, et al.
(author)
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Health-related quality of life after surviving intensive care for COVID-19 : a prospective multicenter cohort study
- 2023
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In: Scientific Reports. - : Springer Nature. - 2045-2322. ; 13:1
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Journal article (peer-reviewed)abstract
- In survivors of severe coronavirus disease 2019 (COVID-19) incomplete mental and physical recovery may considerably impact daily activities and health-related quality of life (HRQoL). HRQoL can be evaluated with the RAND-36 questionnaire, a multidimensional instrument that assesses physical and mental aspects of health in eight dimensions. The objective was to investigate HRQoL in intensive care patients previously treated for COVID-19 at three Nordic university hospitals, in a prospective multi-center cohort study. HRQoL was measured using RAND-36, 3-9 months after discharge from intensive care units (ICU). One hospital performed a second follow-up 12 months after discharge. A score under the lower limit of the 95% confidence interval in the reference cohorts was considered as significantly reduced HRQoL. We screened 542 and included 252 patients. There was more than twice as many male (174) as female (78) patients and the median age was 61 (interquartile range, IQR 52-69) years. Hypertension was the most common comorbidity observed in 132 (52%) patients and 121 (48%) patients were mechanically ventilated for a median of 8 (IQR 4-14) days. In RAND-36 physical functioning, physical role functioning, general health (p < 0.001 for all) and social functioning (p < 0.05) were below reference, whereas bodily pain, emotional role functioning and mental health were not. In a time-to-event analysis female sex was associated with a decreased chance of reaching the reference HRQoL in the physical function, bodily pain and mental health dimensions. Higher body mass index was found in the physical functioning dimension and hypertension in the physical functioning, vitality and social functioning dimensions. Similar results were seen for diabetes mellitus in general health, vitality and mental health dimensions, as well as pulmonary illness in the physical role functioning dimension and psychiatric diagnosis in the social functioning dimension. Mechanical ventilation was associated with a decreased likelihood of achieving reference HRQoL in the bodily pain and physical functioning dimensions. Patients treated in an ICU because of COVID-19 had lower HRQoL 3-9 months after ICU discharge than 95% of the general population. Physical dimensions were more severely affected than mental dimensions. Female sex and several comorbidities were associated with a slower rate of recovery.
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| 6. |
- Hensler, Ida, 1989-, et al.
(author)
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Efficacy, Benefits, and Harms of a Self-management App in a Swedish Trauma-Exposed Community Sample (PTSD Coach) : Randomized Controlled Trial
- 2022
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In: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871. ; 24:3
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Journal article (peer-reviewed)abstract
- Background: Self-guided interventions may complement and overcome obstacles to in-person treatment options. The efficacy of app interventions targeting posttraumatic stress disorder (PTSD) is unclear, and results from previous studies on PTSD Coach—an app for managing trauma-related distress—are inconsistent.Objective: This study investigates whether access to the Swedish version of the PTSD Coach affects posttraumatic stress, depressive, and somatic symptoms. In addition, we aim to assess the perceived helpfulness, satisfaction, negative effects, response, and remission related to PTSD Coach.Methods: Adults who had experienced potentially traumatic events in the past 2 years were randomized (1:1) to have access to PTSD Coach (n=89) or be on the waitlist (n=90). We assessed clinical characteristics at baseline (semistructured interviews and self-rating scales) and after 3 months (self-rating scales). We analyzed the data in R software using linear mixed effects models, chi-square tests, and Fisher exact test.Results: Intention-to-treat analyses indicated that access to PTSD Coach decreased posttraumatic stress and depressive symptoms but not somatic symptoms. More participants who had access to PTSD Coach responded with clinically significant improvement and fewer instances of probable PTSD after 3 months compared with waitlist controls. Overall, participants found that PTSD Coach was slightly to moderately helpful and moderately satisfactory. Half of the intervention group (36/71, 51%) reported at least one negative reaction related to using PTSD Coach (eg, disappointment with the app or its results, arousal of stress, or distressing memories).Conclusions: Using PTSD Coach may trigger symptoms among a few users; however, most of them perceived PTSD Coach as helpful and satisfactory. This study showed that having access to PTSD Coach helped improve psychological trauma-related symptoms. In addition, we have discussed implications for future research and clinical practice.
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| 7. |
- Hensler, Ida, 1989-, et al.
(author)
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Longitudinal follow-up of the randomized controlled trial of access to the trauma-focused self-management app PTSD Coach
- 2023
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In: Internet Interventions. - : Elsevier. - 2214-7829. ; 32, s. 100618-
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Journal article (peer-reviewed)abstract
- Apps that target posttraumatic stress are rarely evaluated and long-term examination of symptom change is rare. In a waitlist-controlled randomized controlled trial, we found that the Swedish version of the self-management app PTSD Coach confers benefits on posttraumatic stress and depressive symptoms after three months use. Here, we aimed to evaluate between-group effects on functional disability as well as within-group changes on mental health, somatic illness and functional disability after access to the Swedish PTSD Coach app during 9 months. In addition, we described negative effects, helpfulness and satisfaction with the app. Among the 179 trauma-exposed adults (92% women) randomized to instant access or delayed access to PTSD Coach, symptoms of posttraumatic stress, depression, somatic illness and functional disability decreased and were maintained within 3 to 9 months of app access. Posttraumatic stress continued to improve during follow up. PTSD Coach was considered slightly to moderately helpful and satisfactory, and 43% reported any negative effect related to using the app. PTSD Coach is an effective self-management intervention for trauma-related distress. Future research should investigate mechanisms of change, as well as individual characteristics that predict symptom reduction after access to PTSD Coach in order to inform clinical practice.
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| 8. |
- Jonsson, Ulf, 1974-, et al.
(author)
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Internet-delivered psychological treatment as an add-on to treatment as usual for common mental disorders : A systematic review with meta-analysis of randomized trials
- 2023
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In: Journal of Affective Disorders. - : Elsevier. - 0165-0327 .- 1573-2517. ; 322, s. 221-234
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Research review (peer-reviewed)abstract
- BACKGROUND: Psychological treatments for common mental disorders are increasingly being delivered remotely via the internet. Evidence suggests that internet-delivered cognitive behavioural therapy (iCBT) is superior to waitlist. However, the benefits are unclear of using this treatment modality as an add-on to treatment as usual (TAU) in regular healthcare.METHODS: The literature was systematically searched up to August 2021 for randomized trials of internet-delivered psychological treatments using TAU as the comparator. Eligible participants were diagnosed with depressive, anxiety, obsessive-compulsive, or trauma- and stress-related disorders. Outcomes of interest were symptoms, functioning, quality of life, healthcare utilization, and negative effects. Results were synthesized using random-effects meta-analyses. Quality of evidence was assessed using GRADE.RESULTS: The included studies evaluated iCBT for adults with depression (k = 9), depressive or anxiety disorders (k = 4), and post-traumatic stress disorder (k = 2) and were conducted in primary care or similar settings. For depression, low-certainty evidence suggested beneficial short-term effects on symptoms (g = -0.23; 95 % CI: = -0.37, -0.09), response rate (OR = 2.46; 1.31, 4.64), and remission (OR = 1.70; 1.19, 2.42;). The certainty of evidence was very low for long-term effects, other outcomes, and other disorders.LIMITATIONS: TAU varied across studies and was often insufficiently described.CONCLUSIONS: iCBT as a complement to usual care for adult with depression may result in a small incremental effect, which potentially could be clinically important. Studies are lacking for several common disorders and for children, adolescents, and the elderly. More robust studies of long-term effects are also needed, to better inform clinical decision-making.
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| 9. |
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