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Mattebo, M., Östlund, G. & Elfström, M. L. (2022). Availability of attachment relations and safe school environment are associated with subjective well-being in 15-year-olds – with girls reporting less well-being and less equality. International Journal of Educational Research Open, 3, Article ID 100145.
Open this publication in new window or tab >>Availability of attachment relations and safe school environment are associated with subjective well-being in 15-year-olds – with girls reporting less well-being and less equality
2022 (English)In: International Journal of Educational Research Open, ISSN 2666-3740, Vol. 3, article id 100145Article in journal (Refereed) Published
Abstract [en]

Background: Understanding young people's subjective well-being, such as how they experience equality, safety, and supportive environments, is particularly important for identifying possible preventive interventions in the school context. Aim: The aim of this study was to investigate similarities and differences between 15-year-old girls’ and boys’ subjective well-being, and its associations with psychosocial factors. Methods: The study was explorative and cross-sectional. A total of 195 adolescent girls and 116 boys in Grade 9 from four Swedish junior high schools completed a questionnaire on subjective well-being; emotional support opportunities; gender equality; experience of emotional, physical, and sexual violence in close relationships; insecurity due to harassment in the school environment or on social media; and pornography consumption. Results: Compared to boys, girls indicated worse subjective well-being and more harassment in school and on social media, and reported that boys received benefits based on gender. Boys reported higher pornography consumption compared with girls. Girls reporting decreased subjective well-being experienced more harassment on social media and in school, and more recent sexual violence. Among boys, with decreased subjective well-being, more psychological risks such as self-harm and suicidal thoughts was reported. Both girls and boys with decreased subjective well-being reported less availability of attachment and insecure close relations. Conclusion: The absence of a safe and supportive environment, such as feeling secure at school, and lack of close and trusting relationships are associated with 15-year-olds’ subjective well-being for the worse, regardless of gender. It is suggested that school personnel extend the relational possibilities in the school context. 

Place, publisher, year, edition, pages
Elsevier Ltd, 2022
Keywords
Emotional well-being, Gender, GP-CORE, Junior high school, Psychosocial health, Young people
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:mdh:diva-59456 (URN)10.1016/j.ijedro.2022.100145 (DOI)2-s2.0-85132303860 (Scopus ID)
Available from: 2022-06-29 Created: 2022-06-29 Last updated: 2023-02-23Bibliographically approved
Aaby, A., Ravn, S. L., Elfström, M. L., Kasch, H. & Andersen, T. E. (2022). Does the Danish version of the Spinal Cord Lesion-related Coping Strategies Questionnaire measure what we think it measures?: A triangulated mixed-methods validation approach. Spinal Cord
Open this publication in new window or tab >>Does the Danish version of the Spinal Cord Lesion-related Coping Strategies Questionnaire measure what we think it measures?: A triangulated mixed-methods validation approach
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2022 (English)In: Spinal Cord, ISSN 1362-4393, E-ISSN 1476-5624Article in journal (Refereed) Epub ahead of print
Abstract [en]

Study design: Triangulated mixed-methods validation study.

Objectives: To validate the Danish version of the Spinal Cord Lesion-related Coping Strategies Questionnaire (SCL-CSQ).

Setting: Community in Denmark.

Methods: Participants were invited via a patient organization and its specialized hospital. Eligibility criteria were having a spinal cord injury (SCI), being 18 years or older, and able to understand and respond in Danish. Quantitative data were collected to determine internal consistency and criterion validity of the three subscales of SCL-CSQ, i.e., acceptance, fighting spirit, and social reliance. The Three-Step Test-Interview approach was employed to determine whether items measured what they were intended to measure (i.e., construct validity based on response processes).

Results: The quantitative sample consisted of 107 participants, and the interview sample comprised 11 participants. The acceptance and fighting spirit subscales showed adequate internal consistency (Cronbach's alpha of 0.72 and 0.76 respectively) and satisfactory criterion validity (expected correlations with quality of life and depression). The social reliance subscale showed inadequate internal consistency (Cronbach's alpha of 0.58) and criterion validity. All fighting spirit items and all but one acceptance items were interpreted congruently by most participants. Conversely, two social reliance items were only interpreted congruently by 9 and 27%.

Conclusion: The acceptance and fighting spirit subscales of the Danish version of the SCL-CSQ showed good psychometric properties, while the social reliance subscale showed serious issues and should be revised. Researchers and clinicians are urged to reflect on these findings when revising the SCL-CSQ or adapting it to other languages, cultural contexts, and rehabilitation settings.

Place, publisher, year, edition, pages
SPRINGERNATURE, 2022
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mdh:diva-59406 (URN)10.1038/s41393-022-00825-7 (DOI)000812608100001 ()35717550 (PubMedID)2-s2.0-85132150428 (Scopus ID)
Available from: 2022-06-29 Created: 2022-06-29 Last updated: 2023-04-12Bibliographically approved
Bose, C. N. & L. Elfström, M. (2022). Experiences of a psychosocial intervention for patients with heart failure at one year after completion: A reflexive thematic analysis. Nordic journal of nursing research, Article ID 205715852211023.
Open this publication in new window or tab >>Experiences of a psychosocial intervention for patients with heart failure at one year after completion: A reflexive thematic analysis
2022 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, article id 205715852211023Article in journal (Refereed) Published
Abstract [en]

Chronic heart failure is a common and a serious condition. Research has shown that chronic heart failure has been associated with detrimental effects on wellbeing. Coping effectiveness training (CET) has been applied for patients with heart failure to improve stress appraisal and stress management skills. The aim of this study was to explore the experience of participating in CET for patients with heart failure one year after completion. Eleven patients were interviewed. The study adheres to the SRQR guidelines. A thematic analysis generated three themes: rewarding but challenging to meet other people with heart failure; improved conditions to cope with stress; and not relevant to me. Implications for further development of the intervention were to include existential aspects, recognize comorbidities, test follow-up sessions and apply a codesign.

Keywords
adaption, psychological, cardiovascular nursing, coping intervention, patient perspective, qualitative analysis
National Category
Nursing
Identifiers
urn:nbn:se:mdh:diva-61207 (URN)10.1177/20571585221102323 (DOI)2-s2.0-85132793516 (Scopus ID)
Available from: 2022-12-12 Created: 2022-12-12 Last updated: 2022-12-12Bibliographically approved
Danielsson, L., Elfström, M., Henche, J. G. & Melin, J. (2022). Measurement properties of the Swedish clinical outcomes in routine evaluation outcome measures (CORE-OM): Rasch analysis and short version for depressed and anxious out-patients in a multicultural area. Health and Quality of Life Outcomes, 20(1), Article ID 30.
Open this publication in new window or tab >>Measurement properties of the Swedish clinical outcomes in routine evaluation outcome measures (CORE-OM): Rasch analysis and short version for depressed and anxious out-patients in a multicultural area
2022 (English)In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 20, no 1, article id 30Article in journal (Refereed) Published
Abstract [en]

Introduction: The Swedish version of the patient-reported Clinical Outcomes in Routine Evaluation Outcome Measures (CORE-OM) has demonstrated high reliability and acceptable convergent validity in explanatory factor analyses. However, the fundamental scale properties have not yet been validated according to item response theory. The aim of this study was to analyze the measurement properties of the Swedish CORE-OM in a cohort of psychiatric out-patients with depression and anxiety in a multicultural area and to explore combinations of items based on shorter versions of the scale (CORE-10, CORE-6D) to improve measurement properties.

Methods: Data from CORE-OM assessments of 337 patients were analyzed using Rasch analysis. The patients had a mean age of 30 +/- 14 years, the majority were women (72%). Requirements for measurement properties were checked: overall model fit, item fit residuals, targeting, internal consistency, differential item functioning and thresholds. Sensitivity to change was also analyzed.

Results: The CORE-OM showed high internal consistency (person separation index = 0.947) and adequate targeting, but there was overall model misfit (item trait interaction chi(2) = 917.53, p < 0.001), indication of local dependency, and differential item functioning in 9 items. The risk items showed problems with disordered thresholds. The emotional component of the shorter CORE-6D showed the best fit for our sample. Adding 3 items to include depressive and trauma-related content resulted in a unidimensional 8-item set with acceptable reliability, model fit, targeting and sensitivity to change.

Conclusion: For out-patients with diagnosed depression or anxiety in a multicultural area, the Swedish CORE-OM showed high internal consistency, but also validity problems. Based on the shorter CORE-6D version, a unidimensional 8-item set could be an alternative brief measure of psychological distress for this population, but further validity studies are required. Qualitative studies exploring the CORE-OM items in non-native speakers are also warranted.

Place, publisher, year, edition, pages
BMC, 2022
Keywords
Psychometrics, Internal validity, Patient-reported outcome measures, Item response theory
National Category
Nursing
Identifiers
urn:nbn:se:mdh:diva-57528 (URN)10.1186/s12955-022-01937-7 (DOI)000758318900002 ()35183201 (PubMedID)2-s2.0-85125020401 (Scopus ID)
Available from: 2022-03-02 Created: 2022-03-02 Last updated: 2022-12-12Bibliographically approved
Hochwälder, J., Gustafsson, L.-K., Östlund, G., Zander, V. & Elfström, M. L. (2022). Psychometric evaluation of the subjective well-being measure GP-CORE in a group of older adults in Sweden.. BMC Geriatrics, 22(1), Article ID 913.
Open this publication in new window or tab >>Psychometric evaluation of the subjective well-being measure GP-CORE in a group of older adults in Sweden.
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2022 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 22, no 1, article id 913Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The world's growing population of older adults is one population that needs to be focused more regarding subjective well-being. It is therefore important to evaluate self-report instruments that measures general well-being for this specific group - older adults. The aim of the present study was to investigate psychometric properties of the Swedish translation of the GP-CORE (general population - Clinical Outcomes in Routine Evaluation) in a group of older adults (> 65 years).

METHODS: In this study, a psychometric evaluation of the GP-CORE is presented for 247 Swedish older adults (> 65 years), 184 women and 63 men who applied for home care assistance for the first time.

RESULTS: The psychometric evaluation showed high acceptability; provided norm values in terms of means, standard deviations and quartiles; showed satisfactory reliability in terms of both internal consistency and stability; showed satisfactory validity in terms of convergent and discriminant validity; provided a very preliminary cut-off value and quite low sensibility and sensitivity and showed results which indicated that this scale is sensitive to changes. One gender difference was identified in that women without a cohabitant had a higher well-being than men without a cohabitant (as measured by GP-CORE).

CONCLUSIONS: The GP-CORE showed satisfactory psychometric properties to be used to measure and monitor subjective well-being in older adults (> 65 years) in the general population of community dwelling. Future studies should establish a cut-off value in relation to another well-being measure relevant for mental health in older adults.

Keywords
GP-CORE, Geriatric mental health, Older adults, Psychometrics, Subjective well-being
National Category
Medical and Health Sciences Health Sciences
Identifiers
urn:nbn:se:mdh:diva-61079 (URN)10.1186/s12877-022-03625-z (DOI)000889533600001 ()36443687 (PubMedID)2-s2.0-85142817038 (Scopus ID)
Available from: 2022-11-30 Created: 2022-11-30 Last updated: 2023-03-30Bibliographically approved
Söderlund, A. & Elfström, M. (2021). Compliance and adherence - concept definitions, barriers and facilitation strategies. International Journal of Behavioral Medicine, 28(SUPPL 1), S91-S91
Open this publication in new window or tab >>Compliance and adherence - concept definitions, barriers and facilitation strategies
2021 (English)In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 28, no SUPPL 1, p. S91-S91Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
SPRINGER, 2021
National Category
Nursing
Identifiers
urn:nbn:se:mdh:diva-55363 (URN)000660029800278 ()
Available from: 2021-07-01 Created: 2021-07-01 Last updated: 2022-09-02Bibliographically approved
Jedel, E., Elfström, M. & Hägglin, C. (2021). Differences in personality, perceived stress and physical activity in women with burning mouth syndrome compared to controls.. Scandinavian Journal of Pain, 21(1), 183-190, Article ID /j/sjpain.ahead-of-print/sjpain-2020-0110/sjpain-2020-0110.xml.
Open this publication in new window or tab >>Differences in personality, perceived stress and physical activity in women with burning mouth syndrome compared to controls.
2021 (English)In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 21, no 1, p. 183-190, article id /j/sjpain.ahead-of-print/sjpain-2020-0110/sjpain-2020-0110.xmlArticle in journal (Refereed) Published
Abstract [en]

Objectives Burning mouth syndrome (BMS) is a long-lasting pain condition which is commonly associated with anxiety symptoms and experience of adverse, stressful life events have been reported by those diagnosed with the syndrome. Stress-related biomarkers have been related to personality traits in BMS and a personality with high stress susceptibility and perceived stress may be of importance. Although biopsychosocial approaches are suggested to manage long-lasting orofacial pain, to date little is known about physical activity in women with BMS. The aim of this study was to investigate if personality, perceived stress and physical activity distinguish women with BMS from controls. Methods Fifty-six women with BMS and 56 controls matched on age and gender completed Swedish universities Scales of Personality (SSP), Perceived Stress Questionnaire (PSQ) and a general questionnaire with an item on weekly physical activity frequency. In addition, health-related quality of life was explored by additional questionnaires and reported in a companion article (Jedel et al. Scand J Pain. 2020. PubMed PMID: 32853174). Results SSP subscales Somatic Trait Anxiety, Psychic Trait Anxiety, Stress Susceptibility and Verbal Trait Aggression differed between women with BMS and controls and the personality factor scores for Neuroticism and Aggressiveness were higher. Perceived stress measured by PSQ index was higher for women with BMS compared to controls. Women with BMS reported lower physical activity frequency compared to controls and those reporting physical activity <4 days/week scored higher on PSQ compared to those with weekly physical activity ≥4 days/week. Conclusions Personality distinguished women with BMS from controls in this study. Perceived stress was higher and weekly physical activity was lower in women with BMS compared to controls. Our findings suggest physical activity should be more comprehensively measured in future BMS studies and, by extension, physical activity may be a treatment option for women with BMS. Pain management aiming to restore function and mobility with stress reduction should be considered in clinical decision making for women with BMS who have a personality with stress susceptibility, especially if reporting high perceived stress and insufficient physical activity.

Keywords
burning mouth syndrome, chronic pain, emotions, personality, physical activity, stress
National Category
Clinical Medicine
Identifiers
urn:nbn:se:mdh:diva-52940 (URN)10.1515/sjpain-2020-0110 (DOI)000609029800021 ()33108343 (PubMedID)2-s2.0-85096005166 (Scopus ID)
Available from: 2020-12-30 Created: 2020-12-30 Last updated: 2021-03-26Bibliographically approved
Henriksson, A., Elfström, M., Söderlund, A., Nordin, K. & von Heideken Wågert, P. (2021). Exploring lived experience of sedentary behavior during cancer treatment: - a phenomenological study. In: : . Paper presented at 8th International Society for Physical Activity and Health (ISPAH) Congress, Online, October 12-14, 2021.
Open this publication in new window or tab >>Exploring lived experience of sedentary behavior during cancer treatment: - a phenomenological study
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2021 (English)Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

Background 

Sedentary behavior (SB) increases during cancer treatment, which may have deteriorating effects on long-term health. Few studies exploring patients' experience of SB during neo- or adjuvant cancer treatment have been conducted, and this information may be crucial in developing effective support for patients to reduce SB.

Purpose 

To explore the lived experiences of SB in patients undergoing neo- or adjuvant cancer treatment and to explore the impact of the COVID-19 pandemic.

Methods

Individual interviews were conducted with patients undergoing treatment for breast, prostate and colorectal cancer recruited from the oncological department of a university hospital in Sweden. Interviews were analyzed phenomenologically and results presented as descriptions of the phenomenon SB. 

Results 

Preliminary results are that patients describe SB by depicting physical activity and awareness of its health benefits. Also, being inactive or sedentary is stigmatized. The type and phase of treatment, life circumstances (COVID-19 pandemic, sick leave) as well as motivation, social support, and self-image can impact SB during treatment.

Conclusions 

The results indicate that SB is difficult for patients to discern. This suggests that SB is an unimplemented concept in the cancer context and needs to be addressed in a way that does not stigmatize patients. The coronavirus pandemic had both negative and positive impacts on SB for these patients. Furthermore, developing support that targets periods with more side-effects and helping patients reduce SB throughout changed life circumstances may be helpful. 

Keywords
COVID-19, experience, oncology, phenomenology, sedentary behavior
National Category
Physiotherapy
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-57531 (URN)
Conference
8th International Society for Physical Activity and Health (ISPAH) Congress, Online, October 12-14, 2021
Funder
Swedish Cancer Society, 200760Pj
Available from: 2022-03-02 Created: 2022-03-02 Last updated: 2022-10-26Bibliographically approved
Östlund, G., Mattebo, M. & Elfström, M. (2021). Teenage girls’ experiences of mental health and well-being from interviews in school settings.. In: : . Paper presented at Nationell forskarkonferens i socialt arbete, NAPSA, Mälardalens högskola, 17-18 Mars.
Open this publication in new window or tab >>Teenage girls’ experiences of mental health and well-being from interviews in school settings.
2021 (Swedish)Conference paper, Oral presentation only (Refereed)
National Category
Social Sciences
Identifiers
urn:nbn:se:mdh:diva-56183 (URN)
Conference
Nationell forskarkonferens i socialt arbete, NAPSA, Mälardalens högskola, 17-18 Mars
Available from: 2021-10-13 Created: 2021-10-13 Last updated: 2021-12-14Bibliographically approved
Eklund, C., Elfström, M., von Heideken Wågert, P., Söderlund, A., Gustavsson, C., Cederborn, S., . . . Lööf, H. (2021). The Meaning of Sedentary Behavior as Experienced by People in the Transition From Working Life to Retirement: An Empirical Phenomenological Study. Physical Therapy, 101(8), Article ID pzab117.
Open this publication in new window or tab >>The Meaning of Sedentary Behavior as Experienced by People in the Transition From Working Life to Retirement: An Empirical Phenomenological Study
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2021 (English)In: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 101, no 8, article id pzab117Article in journal (Refereed) Published
Abstract [en]

Objective

Sedentary behavior (SB) is defined as a mean of >6 hours of daytime sitting or lying down. SB has been shown to increase with older age and is a risk factor for disease. During the transition from working life to retirement, changes in daily life activities occur, risking increased SB. The aim of the present study was to gain a deeper understanding of SB in relation to the transition from working life to retirement as experienced by persons in retirement.

Methods

The study was grounded in a phenomenological life-world perspective. Fourteen semi-structured interviews were conducted with participants aged 64–75. Data were analyzed using the empirical phenomenological psychological method.

Results

The participants described that voluntary sedentary time was positively related to general health and well-being, while involuntary sedentary time was negatively related to health. Increased sedentary time was described as natural when aging. Retirement was expressed as a time for rest after hard work and the ability to choose a slower pace in life. Internal and external demands and daily routines interrupted SB, whereas loneliness was perceived to increase SB. Participants strived to find a balance between physical activity and sedentary time. The variations in the participants’ descriptions formed three typologies: in light of meaningful sedentary behavior, in the shadow of involuntary sedentary behavior, and a dual process – postponing sedentary behavior with physical activity.

Conclusions

Increased SB was perceived as natural when aging, but something that may be postponed by conscious choices. SB was perceived as associated with health, rest and recovery but also with the risk of deteriorating health.

Impact

This knowledge of the experienced meaning of SB could guide the design of health promotion interventions and may be helpful in targeting those in need of support and individualizing interventions to decrease SB in retirement.Lay SummaryThis study reveals how persons in retirement describe sedentary behavior as something healthy but also as unhealthy and that sedentary behavior is natural in aging and can be postponed by physical activity.

Keywords
Healthy Aging, Lifestyle, Phenomenology, Physical Activity, Sedentary
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-54120 (URN)10.1093/ptj/pzab117 (DOI)000736132800010 ()2-s2.0-85115445763 (Scopus ID)
Available from: 2021-05-10 Created: 2021-05-10 Last updated: 2022-10-31Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-5098-8489

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