| 1. |
- Bäärnhielm, Sofie, et al.
(författare)
-
Gott professionellt bemötande kan stärka den utsatta patienten
- 2020
-
Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 117:1-3, s. 35-38
-
Tidskriftsartikel (populärvet., debatt m.m.)abstract
- The Swedish word, 'bemötande', has no direct equivalent in English but refers to contact, treatment and the relationship with a patient. 'Bemötande', in the context of care, concerns amongst other things how the session is conducted and takes place. The experience of a positive 'bemötande' is important for the patient and relatives to be able to feel trust and confidence, as well as to create a well-functioning working alliance. A respectful 'bemötande' is made more difficult by people's need to classify and see individuals as 'us' and 'them'. A positive 'bemötande' can reinforce patients' self-esteem and have an empowering effect. In this article, we discuss positive 'bemötande' in a transcultural psychiatric care context and focus, in particular, upon the vulnerable patient. We also give examples of how an organisation can contribute to good contact with the local community and facilitate the encounter with individual patients.
|
|
| 2. |
- Bäärnhielm, Sofie, et al.
(författare)
-
[Transcultural encounter empowering the vulnerable patient]. : Gott professionellt bemötande kan stärka den utsatta patienten - Kunskap, självreflektion och vårdenhetens arbetssätt kan skapa förutsättningar för ett bra möte.
- 2020
-
Ingår i: Lakartidningen. - 1652-7518. ; 117:1-3, s. 39-42
-
Tidskriftsartikel (refereegranskat)abstract
- The Swedish word, 'bemötande', has no direct equivalent in English but refers to contact, treatment and the relationship with a patient. 'Bemötande', in the context of care, concerns amongst other things how the session is conducted and takes place. The experience of a positive 'bemötande' is important for the patient and relatives to be able to feel trust and confidence, as well as to create a well-functioning working alliance. A respectful 'bemötande' is made more difficult by people's need to classify and see individuals as 'us' and 'them'. A positive 'bemötande' can reinforce patients' self-esteem and have an empowering effect. In this article, we discuss positive 'bemötande' in a transcultural psychiatric care context and focus, in particular, upon the vulnerable patient. We also give examples of how an organisation can contribute to good contact with the local community and facilitate the encounter with individual patients.
|
|
| 3. |
- Leiler, Anna
(författare)
-
Mental Health and Quality of Life Among Individuals in Asylum Accommodations : Screening and Intervention
- 2021
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Refugees have often experienced traumatic events that could be classified as disasters before leaving their home countries. They are further distressed by difficult experiences while in flight and after reaching the new country. Since the experience of traumatic events is associated with an increased risk of subsequent mental health problems, recommendations regarding psychosocial support after disasters have been established. Two examples are the screen and treat approach, and active monitoring. According to these recommendations, individuals who have experienced a disaster ought to be screened for mental health problems one month after the disaster, and those with persisting symptoms of distress should be offered treatment. The general aim of this thesis is to assess the possibility and appropriateness of applying a screen and treat approach to the mental health of refugees.Four studies are included in the thesis. The first study assessed the mental health and quality of life among individuals living in refugee housing facilities in Sweden. The results showed that the prevalence of symptoms of anxiety, depression and PTSD was high, and that the included participants rated their quality of life as low. Individuals without residence permits generally had worse outcomes than those who had received a residence permit. In the second study, the ability of the Refugee Health Screener (RHS, an instrument developed for assessment of emotional distress among newly arrived refugees) to distinguish between different levels of symptom severity was assessed. By comparing the scores on the RHS with scores on other established scales with cutoffs indicating symptom severity, we identified cutoff values for mild, moderate, and severe distress. In the third study, these cutoffs were further assessed by an investigation of the association between suicidal ideation and symptom severity. The odds of an individual having suicidal ideation increased notably at each severity level. More than half of the individuals with severe distress had suicidal ideation, indicating that they needed support. The fourth study is a pilot study assessing potential effectiveness, acceptability and feasibility of a group psychoeducational intervention delivered at asylum accommodations. The results showed that the intervention was promising in alleviating symptoms of distress and insomnia. It also seemed to be acceptable to both participants and staff, even though some sessions require further elaboration. To deliver the intervention in the midst of the asylum process was demanding, but feasible. This was an early evaluation but shows that the transition to an RCT is reasonable. Taken together, the results of the four studies indicate that the mental health needs among newly arrived refugees are considerable, that the RHS can be used to identify individuals with differing needs of mental health care, and that high levels of distress are associated with suicidal ideation. The results also indicate that it is possible and meaningful to provide psychosocial interventions to individuals at asylum accommodations. This indicates that it could be possible to implement a screen and treat approach to the mental health of refugees. However, if access to treatment cannot be assured, only implementing the screening would neither be ethical nor appropriate.
|
|
| 4. |
- Strand, Mattias, et al.
(författare)
-
Migration background, eating disorder symptoms and healthcare service utilisation : findings from the Stockholm Public Health Cohort
- 2023
-
Ingår i: BJPsych Open. - : Cambridge University Press. - 2056-4724. ; 9:6
-
Tidskriftsartikel (refereegranskat)abstract
- Background: From a global perspective, eating disorders are increasingly common, probably because of societal transformation and improved detection. However, research on the impact of migration on the development of eating disorders is scarce, and previously reported results are conflicting.Aims: To explore if eating disorder symptom prevalence varies according to birth region, parents' birth region and neighbourhood characteristics, and analyse if the observed patterns match the likelihood of being in specialist treatment.Method: This study uses data from a large population-based health survey (N = 47 662) among adults in Stockholm, Sweden. A general linear model for complex samples, including adjustment for gender and age, was used to explore self-reported eating disorder symptoms. Odds ratios were calculated for individual symptoms.Results: Eating disorder symptoms are substantially more common in individuals born abroad, especially for migrants from a non-European country. This holds true for all surveyed symptoms, including restrictive eating (odds ratio 5.5, 95% CI 4.5-6.7), compensatory vomiting (odds ratio 6.1, 95% CI 4.6-8.0), loss-of-control eating (odds ratio 2.6, 95% CI 2.3-3.1) and preoccupation with food (odds ratio 2.3, 95% CI 1.9-2.8). Likewise, symptoms are more common in individuals with both parents born abroad and individuals living in districts with a high percentage of migrant residents. A gap exists between district-level symptom scores and the likelihood of being in specialist eating disorder treatment.Conclusions: These findings call for oversight of current outreach strategies, and highlight the need for efforts to reduce stigma and increase eating disorder symptom recognition in broader groups.
|
|
| 5. |
- Strand, Mattias, et al.
(författare)
-
The Cultural Formulation Interview as a clinical tool in the assessment of eating disorders : a pilot study
- 2024
-
Ingår i: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 15
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The Cultural Formulation Interview (CFI) in the DSM-5 is a person-centered instrument for systematically appraising the impact of sociocultural factors in psychiatric assessment. The CFI has been shown to be feasible, acceptable, and useful in various clinical contexts. However, to this date there is only one published report describing the use of the CFI with patients with eating disorders.Aims: To explore the potential benefits and challenges of utilizing the CFI in the assessment of eating disorders.Methods: As an addendum to an ongoing qualitative study about barriers to treatment for eating disorders for individuals with a migration background in Sweden, we utilized the CFI in the assessment of adult patients (n=8) in specialist eating disorder treatment. Interview data were analyzed employing a thematic analysis framework. Participants provided feedback using a standard form for evaluation of the CFI.Results: Certain CFI questions proved especially meaningful in this context. In response to the CFI question about patient explanatory models, previously unrecognized ideas about causation emerged. These included perfectionism—a known risk factor for eating disorders—based on immigrant parents’ career expectations and experiences of strict family control over life choices. In response to the CFI questions on cultural identity and its impact, the participants provided rich descriptions including important themes such as religion, racism, and ambiguities associated with being a second-generation immigrant. The final CFI question, eliciting concern about the patient-clinician relationship, revealed numerous examples of prejudice and unfamiliarity with migrant groups among healthcare providers.Implications: The CFI can be useful in the assessment of patients with eating disorders and should be further explored as a standard tool in specialist eating disorder services.
|
|
| 6. |
- Uhlin, Karin, et al.
(författare)
-
Interdisciplinary pain rehabilitation for immigrants with chronic pain who need language interpretation
- 2024
-
Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden. - 1650-1977 .- 1651-2081. ; 56
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate outcomes in patients with chronic pain after participation in an interdisciplinary pain rehabilitation programme with language interpreters, and to investigate the outcomes in women and men separately.Design: Prospective multi-centre cohort study. Patients: Ninety-five patients in Sweden with chronic pain who have insufficient knowledge of the Swedish language.Methods: Duration and intensity of pain, anxiety and depression, health-related quality of life and fear of movement were evaluated before and after the pro-gramme. Patients were compared with a reference group comprising Swedish-speaking patients participating in an ordinary interdisciplinary pain rehabilitation programme.Results: Before the interdisciplinary pain rehabilitation programme with language interpreters, all variables except pain duration differed significantly to the detriment of the studied group. The studied group showed significant improvements after the interdisciplinary pain rehabilitation programme with language interpreters, with regards to pain inten-sity, depression and fear of movement. The reference group improved significantly for all variables. The women in the studied group showed significant improvements for the same variables as the whole group, while the men in the studied group did not improve in any of the variables.Conclusion: This study indicates that patients with chronic pain, and especially women, who have insufficient knowledge of Swedish seem to benefit from participating in an interdisciplinary pain rehabilitation programme with language interpreters. The result may be of value for the further development of rehabilitation programmes with language interpreters.
|
|
| 7. |
- Wallin, Malin Idar, et al.
(författare)
-
A qualitative analysis of the documentation of DSM-5 Cultural Formulation Interviews with non-native speaking patients in a Swedish mental health care setting
- 2024
-
Ingår i: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 15
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Cultural variety in expressed symptom presentations of mental health problems creates difficulties in transcultural diagnostic assessments. This emphasizes the need of culturally sensitive diagnostic tools like the Cultural Formulation Interview (CFI). Although the CFI is being implemented worldwide there is a lack of studies analyzing what kind of information it provides when used with new patients in routine psychiatric assessments, and how CFI information contributes to diagnostic evaluations. This study aimed to find out what information the CFI questions revealed when used with non-native Swedish speaking patients. We also wanted to understand how the CFI may facilitate identification of psychiatric diagnoses among these patients.Materials and methods: The CFI was used as part of a routine clinical psychiatric assessment in an outpatient clinic in Sweden. Interpreters were used in the consultations when needed. A qualitative thematic analysis was used to analyze the documented CFI answers from non-native speaking patients.Results: We found that the CFI information contained contextualized descriptions of dysfunction and current life conditions, as well as expressions of emotions, often described along with somatic terms.Discussion: Our results indicate that the narrative approach of the CFI, giving contextualized information about distress and functioning, can facilitate clinicians’ identification of psychiatric symptoms when language, psychiatric terms and understandings are not shared between patient and clinician.
|
|
| 8. |
- Wallin, Malin Idar, et al.
(författare)
-
What information did the DSM-5 Cultural Formulation Interviews provide when used with Swedish-speaking patients in a psychiatric setting in Stockholm?
- 2024
-
Ingår i: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 15
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Cultural and contextual factors affect communication and how psychiatric symptoms are presented, therefore psychiatric assessments need to include awareness of the patients’ culture and context. The Cultural Formulation Interview (CFI) in DSM-5 is a person-centred tool developed to support the exploration of cultural and contextual factors in an individualized and non-stereotypic way.Methods: The aim of this qualitative study was to find out what information the DSM-5 CFI revealed when used with native Swedish-speaking patients as part of routine clinical psychiatric assessment at an outpatient clinic. An additional aim was to enhance understanding of what kind of information the questions about background and identity yielded. The CFI was added to the psychiatric assessment of 62 native Swedish-speaking patients at an outpatient psychiatric clinic in Stockholm.Results: From the thematic analysis of the documented CFI answers, six central themes were found; Descriptions of distress and dysfunction, Managing problems and distress, Current life conditions affecting the person, Perceived failure in meeting social expectations, Making sense of the problem, and Experiences of, and wishes for, help. The CFI questions about identity yielded much information, mainly related to social position and feelings of social failure.Discussion: For further refinement of the CFI, we see a need for re-framing the questions about cultural identity and its impact on health so that they are better understood. This is needed for majority population patients as direct questions about culture may be difficult to understand when cultural norms are implicit and often unexamined. For clinical implications, our findings suggest that for cultural majority patients the DSM-5 CFI can be a useful person-centred tool for exploring cultural and, in particular, social factors and patients’ perception and understanding of distress.
|
|
| 9. |
- Westerberg, Britta, 1988-, et al.
(författare)
-
An Internet Based Intervention for Adults With Autism Spectrum Disorder - A Qualitative Study of Participants Experiences
- 2021
-
Ingår i: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 12
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Adults with autism spectrum disorder face several barriers to accessing evidence-based care, including difficulties in communicating needs, social anxiety or in traveling to a health care unit. In recent years, several forms of internet-based treatments have shown to be effective for a variety of psychiatric conditions. Internet-based treatment alternatives allow convenient and flexible formats, and therefore have the potential to increase access to health care for individuals with autism spectrum disorder. However, knowledge about how internet-based treatment features may suit the needs of individuals with autism is limited. The aim of this study was to explore the participant experiences of an internet-based intervention for adults with autism spectrum disorder. The primary focus of the investigation was on autism-specific needs in relation to the features unique to the online format.Methods: In this qualitative study, semi-structured telephone interviews were conducted with 14 participants who had completed a text-based internet-based intervention for adults with autism spectrum disorder. We used an inductive approach and analyzed the data using qualitative content analysis.Results: Five main categories were identified: (1) implications of the online format, (2) the fixed non-individualized model, (3) therapist interaction, (4) interacting with other participants, and (5) making use of the treatment content. Overall, participants appreciated the availability and that they could work on their treatment independent of time or location. Among those participating in group-based chat-sessions with the other participants, it was considered a generally positive experience. Furthermore, most participants felt safe and relaxed in relation to the therapist and appreciated the text-based format. However, several participants felt that the format and content of the treatment was not sufficiently adapted to their individual life situation.Conclusion: In conclusion, this internet-based treatment constitutes an accessible and energy-saving treatment alternative for adults with autism. Further, integrating group-based components seems feasible in an otherwise individual internet-based treatment for individuals with autism. However, group-based components do require a clear purpose and rationale. Future studies should develop and evaluate treatment adaptations tailored to individual needs.
|
|
