| 1. |
- Arwidson, Charlotta, et al.
(författare)
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(Over)crowded house : exploring asylum seekers' experiences of the COVID-19 pandemic while living at accommodation centers in Sweden
- 2024
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Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe COVID-19 pandemic has made visible the scale of health disparities in society, highlighting how the distribution of infection and deaths differs between population subgroups within countries. Asylum seekers represent a potentially vulnerable group; early in the pandemic, concerns were raised about their housing situation, usually involving overcrowded, camp-like accommodations, and the effects of COVID-19 in relation to this. Hence, this study aimed to explore asylum seekers' experiences of the COVID-19 pandemic while living at accommodation centers.MethodsIn this qualitative study, 14 semi-structured interviews were conducted with asylum seekers at two accommodation centers in Sweden. Participants represented a diverse group of asylum seekers in regard to age, educational background, and gender. Data were analyzed using qualitative content analysis.ResultsExperiences related to COVID-19 were highly dependent on the living situation at the accommodation centers and the experience of feeling unsafe in shared spaces. This was enhanced by the experiences of a challenging mix of COVID-19 messages where different understandings of COVID-19 and related measures existed, together with a feeling of loss of control and safety in shared rooms. Additionally, participants felt more isolated from the outside society and missed prior social activities. Adding to this experience of isolation was an increasing mistrust regarding the authorities' pandemic response.ConclusionThis study highlights the importance of understanding the specific challenges and vulnerabilities of asylum seekers at accommodation centers during the pandemic, shaped by their housing situation and legal status. The findings underscore the need for context-specific support, holistic disease prevention approaches, and tailored health communication strategies using diverse formats. Additionally, the findings emphasize the crucial need to identify and mobilize existing community resources in planning and implementing pandemic control measures. Furthermore, the study emphasizes governmental responsibility in providing secure housing, and to address long-term vulnerabilities beyond pandemics.
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| 2. |
- Gottberg, Kristina
(författare)
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Studies of people living with multiple sclerosis in Stockholm county : evaluation of methods for data collection and aspects of functining and use of health care services
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Multiple sclerosis (MS) is a demyelinating disease of the central nervous system with potential consequences to both the physical and psychosocial dimensions of functioning in afflicted individuals. The aim of this thesis was to evaluate the methods of data collection by means of home visits to people with MS (PwMS) using a comprehensive protocol with structured interviews and tests on functioning, health-related quality of life (HRQoL), use of health care services and satisfaction with care, complemented by data collection through a register of use of health care services. Furthermore, the aim was to describe and analyse HRQoL and prevalence of depressive symptoms with respect to sociodemographic and disease-related factors and sense of coherence (SOC), and to describe and analyse use of health care services and satisfaction with care, in a population-based sample of PwMS in Stockholm. Two separate data collections were performed via face-to face structured interviews and tests in the homes of PwMS, and via a register of health care services. The sample used for the pilot study consisted of 26 purposefully selected PwMS, with different levels of disabilities and modes of living. The sample (n= 166) used in the second data collection was population-based, with PwMS identified from a stratified 15% of a pool of 2,129 individuals compiled from lists from various sources, mainly from the departments of neurology in Stockholm County, and subject to a number of inclusion criteria. The comprehensive protocol used at the home visits comprised a number of tests and questionnaires on functioning and HRQoL, including the Sickness Impact Profile (SIP), the Euroqol-5D (EQ-5D), the Beck Depression Inventory (BDI) and questionnaires on the use of services and satisfaction with care. Data on the use of health care services during a three-year period prior to each home visit to PwMS, by means of out-patient and ih-patient care, was collected through a computerized register at Stockholm County Council. The pilot studies showed that the chosen methods for describing functioning, HRQoL, use of health care services and satisfaction with care were feasible for PwMS, irrespective of level of disability or mode of living. The protocol used at the home visits was well accepted by both PwMS and family caregivers, and needed only minor modifications in make them suitable for the population-based study. Further, the register of health care services was considered a reliable source of information for evaluating detailed use of services by PwMS over a three-year period. In the population-based sample, HRQoL was negatively affected in all dimensions measured, but especially in home management, walking and recreation. HRQoL was poorer in PwMS, including those with milder disease and shorter disease duration, than in the general population. Not working, higher disease severity, and weak SOC were independently associated with major impact on HRQoL. One fifth (19%) of the PwMS were depressed, as measured by the BDI. Depressed PwMS reported poorer HRQoL than the non-depressed in several aspects. Depressive symptoms were associated with poor memory function, but not with any of the other measures of functioning; measures on attention, walking speed, manual dexterity, ADL, or frequency of social/ lifestyle activities. Higher proportions of PwMS with depressive symptoms were found among those with weak SOC than in those with moderate to strong SOC. During the study period of three years prior to each home visit of PwMS, high proportions of PwMS used hospital and primary care in parallel, with many departments and services involved. Primary care constituted 54% of all out-patient care and hospital neurology care constituted 20%. A mean proportion of 24% was annually admitted to in-patient hospital care. In all, 73% of the PwMS had assistive advices at home, 45% had home adaptations and 64% had permits for health-related transportation service. Some 37% used informal care from partners. PwMS were in general satisfied with care, but certain areas with which higher proportions of PwMS expressed dissatisfaction concerned accessibility of practical psychosocial advice and support and rehabilitation periods, and the participation of PwMS in planning of their care. Considering the broad impact on HRQoL in most PwMS and the high prevalence of depressive symptoms, attention to health and functioning - from the perspective of PwMS - is strongly indicated in the management of MS. Further, health-care units engaged in MS management should survey the totality of services available for PwMS when planning and implementing individualized care interventions, since most PwMS will already be receiving care in more than one department or unit. The development of evidence-based, cost-effective health-care services to improve HRQoL and well-being is warranted; i.e., interventions, both somatic and psychological, that optimize health in a comprehensive perspective.
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| 3. |
- Järemo, Pirjo, et al.
(författare)
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Facing Invalidation : A Further Challenge when Living with Chronic Widespread Pain
- 2022
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Ingår i: Journal of Rehabilitation Medicine. - : Foundation for Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 54
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The concept of "invalidation" refers to the patients perception that the social environment does not recognize their medical condition. This study explores and describes invalidation experiences among Swedish patients with chronic widespread pain with regard to sociodemographic and pain characteristics, impact of pain, self-reported health, and symptoms of anxiety and depressive. Methods: A cross-sectional design using questionnaires, including sociodemographic and pain variables, the Illness Invalidation Inventory (Likert scale items regarding 5 sources), the Hospital Anxiety and Depression Scale, and the Short-Form General Health Survey. Descriptive and univariate analyses were applied. Results: Of the 152 respondents, 91% were women. Swedish patients with chronic widespread pain experienced invalidation to a large extent from all sources. The highest scores for invalidation were reported from contacts with social services (68%), and the lowest from spouses (30%). Being younger (p < 0.006), having periodic pain (p = 0.011), and having had more frequent visits to a doctor in the previous year (p = 0.007) were characteristics associated with higher invalidation scores. Experiences of invalidation were associated with worse self-reported mental health scores (r = -0.29 to -0.46). Conclusion: Since patients with chronic widespread pain frequently experience invalidation from the social environment, this further challenge in daily life must be taken into consideration in pain management within multimodal pain rehabilitation.
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| 4. |
- Jönsson, Ann-Cathrin, et al.
(författare)
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Omvårdnad vid stroke
- 2015
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Ingår i: Omvårdnad vid neurologiska sjukdomar. - 9789144055008 ; 1:1
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Bokkapitel (populärvet., debatt m.m.)
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| 5. |
- Kierkegaard, Marie, et al.
(författare)
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Online self-management fall prevention intervention for people with multiple sclerosis : a feasibility study protocol of a parallel group randomised trial
- 2022
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 12:7
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Falls among people with multiple sclerosis (PwMS) are common and associated with injuries, fear of falling and low health-related quality of life. Considerations of behavioural, environmental, psychological and physical influences (including ambulation status) are needed to meet fall prevention needs for PwMS. Thus, using a codesign process involving key stakeholders a novel online self-management fall prevention intervention was created specifically for ambulatory and non-ambulatory PwMS. The feasibility, acceptability, fidelity and outcome of this complex intervention will be explored. Findings will inform a future full-scale randomised controlled trial.METHODS AND ANALYSIS: A mixed-method design will be used. Forty-eight PwMS, stratified for ambulation level, will be randomised to control (n=24) or intervention (n=24). Both groups will receive a brochure about fall risk factors and fall prevention. The intervention is group-based (eight PwMS in each group); will be delivered online; and involve six, 2-hour weekly sessions and a booster session 8 weeks after the sixth session. Each intervention group will be led by a trained facilitator. Data collection will be performed at baseline, and after seven and 18 weeks. Outcome measures will capture data on fall prevention behaviours, fear of falling, falls self-efficacy, social and everyday activities, perceived impact of MS and number of falls. Feasibility of recruitment process, data collection procedures, outcome measures, and delivery, and intervention acceptability, fidelity and outcomes will be evaluated. Both quantitative and qualitative methods will be used.ETHICS AND DISSEMINATION: Ethical approval has been obtained from the Swedish Ethical Review Authority (registration number 2021-04817). Results will be disseminated in peer-review journals, at conferences, research meetings, in social media and through the patient organisation Neuro Sweden.TRIAL REGISTRATION NUMBER: NCT04317716.
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| 6. |
- Tuvemo Johnson, Susanna, et al.
(författare)
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Self-management of falls in people with multiple sclerosis : A scoping review
- 2023
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 37:2, s. 162-176
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Tidskriftsartikel (refereegranskat)abstract
- Objective Falls are common in people with multiple sclerosis. There is rising interest in how the multifactorial and chronic nature of fall risk among people with multiple sclerosis can be addressed through self-management. Thus, the aims were to investigate the extent and the scope of publications on self-management of falls in people with multiple sclerosis, and to identify how the concept of self-management was defined and used. Data sources A systematic literature search in Medline, Cochrane, Web of Science and PsycInfo was conducted to identify publications until July 2022. Review methods Published methodological guidance was followed. Articles targeting: (1) people with multiple sclerosis, (2) falls, and (3) self-management were selected. Of 1656 records, 203 publications were assessed for eligibility, of which 173 did not meet the inclusion criteria, and 16 publications did not contain empirical data. The type of publication, study focus, and study design was extracted. If applicable, key findings, self-management tasks and skills, and the definition of self-management were extracted. Results Fourteen original articles met all inclusion criteria. Ten articles represented six different fall prevention interventions. Three publications were randomized controlled trials. Self-management content was variable and not comprehensive in nature. None of the 14 publications included a self-management definition. Conclusion The limited number of original articles and the even fewer intervention studies show that the research on self-management of falls in people with multiple sclerosis is in its infancy. To progress in the research area of self-management of falls, a more robust, consensus-based description of self-management frameworks and activities is needed.
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| 7. |
- van Eggermont Arwidson, Charlotta, et al.
(författare)
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Living a frozen life : a qualitative study on asylum seekers’ experiences and care practices at accommodation centers in Sweden
- 2022
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Ingår i: Conflict and Health. - : Springer Science and Business Media LLC. - 1752-1505. ; 16:1, s. 1-14
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundForced migrants fleeing conflict and violence face a high risk of mental health problems due to experiences before displacement, perilous journeys, and conditions in the new host societies. Asylum seekers seem to be in particularly vulnerable situations, indicated by higher prevalence rates of mental health problems compared to resettled refugees. Asylum seekers’ mental health is highly influenced by the conditions they face in host countries while awaiting a decision on their case. In Sweden, 40% of asylum seekers reside in state-provided accommodation centers during the asylum process. Collective accommodation centers for asylum seekers have been said to impose restrictive social conditions and to be associated with poorer mental health outcomes than other housing forms (e.g., self-organized housing). However, there seems to be a scarcity of qualitative studies exploring the experiences of asylum seekers in different contexts. The aim of this study was therefore to explore the experiences of asylum seekers and how they manage their mental wellbeing while living at accommodation centers in Sweden.MethodsFourteen semi-structured interviews with asylum seekers were conducted at two accommodation centers in Sweden. Participants were recruited using purposeful sampling and represented a diverse group of asylum seekers regarding age, background, and gender. The data was analyzed using content analysis.ResultsThree overarching categories were identified; 1) Frozen life, 2) Constant worrying and “overthinking”, and 3) Distractions and peer support. Participants experienced a state of being that could be characterized as a frozen life, which was associated with intense feelings of psychological distress, mostly described as manifesting itself in consuming patterns of ruminative thoughts, for instance overthinking and constant worrying. However, despite high levels of distress, participants demonstrated agency in managing negative mental health outcomes through self-care practices, peer support, and the development of care practices in caring for others in need.ConclusionThis study offers new insights into the everyday challenges that asylum seekers at accommodation centers face. Furthermore, it offers valuable observations of how asylum seekers at accommodation centers cope through self-care practices, peer support, and care practices in caring for peers in need. In order to enable sustainable and empowering support, mental health and psychosocial support services must identify and address both challenges and strengths, be grounded in the lived reality of asylum seekers, and build on existing resources. Moreover, further policy work needs to be done to enable faster asylum processes.
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| 8. |
- Ytterberg, Charlotte, et al.
(författare)
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A qualitative study of cognitive behavioural therapy in multiple sclerosis : experiences of psychotherapists
- 2017
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2631. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To investigate how psychotherapists experience using individual, face-to-face cognitive behavioural therapy (CBT) aimed at alleviating depressive symptoms in persons with multiple sclerosis (MS).METHOD: Semi-structured interviews with three psychotherapists were conducted after CBT with 12 participants with MS, and analysed using qualitative content analysis.RESULTS: Two main themes emerged: Trusting their expertise as psychotherapists whilst lacking MS-specific knowledge, and The process of exploring the participants' readiness for CBT with modifications of content and delivery. The psychotherapists perceived it difficult to know whether a symptom was attributable to depression or to MS, and for some participants the CBT needed to be adapted to a more concrete content.CONCLUSIONS: Psychotherapists may need more MS-specific knowledge and an insight into the individual's functioning. The content of CBT in terms of concrete home assignments and behavioural activation needs to be individualised.
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