https://www.mdu.se/

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.

A work can be a risk or a protection factor and the demands it puts on the employee can have different consequences. Work environment includes both physical and psychosocial work environment, the physical part is about noise, ventilation and light. The psychosocial work environment is about social support, influence and demands. Work environment is an important pillar in public health because people spend a lot of time in their work. The purpose of this study is to describe the prison guards experience their work environment. The Demand-Control-Support-model have been used in this study as theoretical perspective.

To get the purpose answered, a qualitative method was done with a goal-directed selection where five prison guards were interviewed individually. All the interviews were semi-structured and recorded then transcribed, and afterwards analysed. The interview person who was interviewed are working in the same prison and have worked there for different amount of time.

The results showed that the interview persons felt that the management put a high pressure even if they are short of staff and nothing has changed even if the staff remarks it. The psychosocial work environment for the interview persons was that the work is psychologically stressful because of the high demands from the management and even the daily threat from the inmates. But the interview persons felt that collaboration among the colleagues is so good that the job satisfaction increase.

Keywords: Demand-Control-Support model, Prison guard, Qualitative method, Work environment.

Every individual ‍in Sweden should have the same right to work in everyday life, and that includes all individuals no matter what gender, ethnicity, religion, sexual orientation, disability, education, or social class the individual has. These aspects should not be convincing to then be excluded from working. Working is considered part of a human right and individuals who are outside the labor market should be included regardless of the aspect they receive that is considered prejudice in society. Recruiters are considered to have a big role of hiring people of various qualities which in turn promotes diversity in companies, hereafter recruiters were selected to be a focus area in the present study. The aim of the present study is to increase the understanding of how different recruiters in Sweden work to promote diversity when recruiting for companies. A qualitative method applying semi-structured interviews was used. Ten interviews were conducted, and the respondents worked as recruiters in different industries, with different years of experience and education. The collected material has been analysed through a manifest content analysis. The result shows that recruiters follow their gut feeling about the candidate, but mostly based on the qualities that the candidate possesses that are also in demand from the position applied for; however, it is not excluded that discrimination may occur during recruitment. The thesis concludes that society makes demands on how companies should adapt when it comes to underrepresented groups in society and recruiters want to meet the needs that exist with the right tools. Several of them recognize that discrimination exists in their respective fields of work: they suggest that hiring people of ethnic minorities is sometimes regarded as a risk taking, and they describe a prevalence of a fear of conflicts based on cultural differences. The interviewees underline that diversity work should continue to be an active topic in working life. 

Background: Participation in healthcare is important, it’s written in laws. Previous research indicates that healthcare professionals and patients do not have the same view of the concept of participation. Highlighting the patient’s lived experiences of participation in child and adolescent psychiatry makes it visible what participation means for the patient. It can help to increase the knowledge of healthcare professionals and improve the care for patients. Aim: The purpose of the study is to describe what young adults experienced as participation during the period they themselves have been patients in child and adolescent psychiatry. Method: A qualitative design with inductive approach. Appropriate selection with 8 participants in the ages 18-20. The interviews were transcribed and analyzed with qualitative content analysis. Results: The result is written in four categories: to be confirmed, to get space, to understand oneself, to understand the context, these categories also received subcategories. The categories and subcategories formed a theme: to get support to grow. Conclusion: The concept of participation has many meanings. Being confirmed in the situation you are in and feeling confident becomes important in the relationship with the healthcare professional. A secure relationship promotes the patient’s participation in healthcare.

Shortage and turnover of registered nurses are worldwide challenges, and work motivation is one factor in retaining staff in the healthcare sector. The aim of this study was to explore registered nurses' motivation expressed in daily communication, using the basic needs in self‐determination theory as a framework. A secondary analysis of ethnographic data, collected through participant observations, informal interviews during observations, and individual interviews, was used. A total sample of all registered nurses employed at a hospital unit in Sweden (n = 10) participated. The data were analyzed thematically through the lens of the basic needs in self‐determination theory: autonomy, competence, and relatedness. Self‐regulation of learning, the possibilities to discuss work‐related challenges with colleagues, and having registered nurses lead dialogues with physicians were factors connected to autonomy. Having a registered nurse and physician solve problems together was a factor connected to competence. A sense of belonging and security in a permissive climate between registered nurses was connected to relatedness. This paper has implications for increased awareness of the three basic motivational needs, which could be used in the development of attractive workplaces.

Children in need of special support in preschool (INS) often exhibit delayed time processing ability (TPA) which can significantly impact their everyday functioning (EDF).This study evaluates whether the MyTime intervention could improve TPA and EDF in preschool children aged five to six-year INS.A registered randomized controlled trial (ISRCTN85136134) using a waiting-list control group investigated the effectiveness of MyTime, an occupational therapy intervention program given to preschool children INS in their classrooms for 8 weeks. Data collection included KaTid-Child (R) for the assessment of TPA, the Time-Parent scale, the Adaptive Behavior Assessment System, and the Autonomy scale for assessing EDF. To evaluate between-group differences, data were analyzed using linear regression.The results show that both groups improved from baseline to post-intervention in TPA and everyday functioning but at the post-intervention, there were no between-group differences.To summarize, the MyTime intervention, indicated an increase in TPA and EDF but no between-group differences were found. Early cognitive levels of TPA in preschool children INS advocate for a longer intervention period. It is possible that long-term follow-up or additional measuring of the teacher's attitudes and the children's engagement in the preschool context could have yielded other results.

Bakgrund: Anestesi är en utsatt situation för patienter där anestesisjuksköterskor har en väsentlig roll genom att vara ett stöd för, informera, stödja delaktighet och motverka anestesirelaterade komplikationer. Awareness är en anestesirelaterad komplikation och innebär att patienter återfår medvetandet under operation, ofta till följd av otillräcklig anestesi. Forskning visar på faktorer som påverkar förekomsten av awareness, men belyser inte i lika stor utsträckning patienters egna upplevelser av awareness. Syfte: Syftet är att beskriva patienters upplevelser i samband med awareness under generell anestesi. Metod: Systematisk integrativ litteraturöversikt av 21 artiklar enligt Whittemore och Knafls modell. Resultat: Patienter som upplevde awareness under generell anestesi beskrev smärtsamma och icke-smärtsamma taktila intryck. De beskrev även visuella- och auditiva intryck, samt förmågan eller oförmågan att påkalla uppmärksamhet. Patienter upplevde även akuta känslomässiga reaktioner, kognitiv närvaro eller frånvaro samt psykosociala följder efter awareness. Slutsats: Examensarbetet redogör för patienters fysiska och psykiska upplevelser under awareness. Upplevelserna som beskrivs är dels negativa och beroende på hur patienter upplevt awareness gav händelsen upphov till olika svåra postoperativa komplikationer. Awareness är ett komplext fenomen som kräver vårdvetenskapliga teorier och vetenskapliga metoder som kan göra komplexiteten rättvisa. 

In this study, we map and describe the coping methods used by members of the university community in Sweden to deal with the first wave of the coronavirus pandemic. This study, which used simple random sampling, was quantitative. It employed a modified version of the RCOPE instrument as well as items from earlier studies of meaning-making coping in Sweden. Among participants (n = 277, 64% women), the most frequently used coping method was nature as a resource in dealing with stress and sadness, followed by listening to the sounds of surrounding nature and thinking of life as part of a greater whole; these coping methods were the most common in all subgroups studied. We used a cultural perspective to better understand the application of certain meaning-making coping methods.

Introduction: Alzheimer's disease (AD) is one of the world's leading public health challenges. One-third of AD cases are attributable to modifiable vascular and lifestyle related risk factors. The Multimodal Preventive Trial for Alzheimer's Disease, MINDADMINI a 6-month multinational parallel-group randomized controlled trial (RCT), targeted persons with prodromal AD and built on the positive outcomes from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) trial. The intervention consisted of four main components of (i) physical exercise training program, (ii) nutrition guidance, (iii) cognitive training, and (iv) social stimulation, as well as (iv) monitoring of metabolic/vascular risk factors.

Aim: The study aimed to explore and describe the experiences of participation in MINDADMINI among persons with prodromal AD.

Methods: This qualitative study was part of the larger MIND-ADMINI project. Eight participants were interviewed twice, before and after the intervention. The data was analyzed using qualitative content analysis.

Results: The results are presented as categories of (i) knowledge of AD and prevention, (ii) motives for study participation, (iii) experiences of the received information about the study, (iv) taking the decision to participate, (v) expectations on study participation, (vi) experiences of study participation and (vii) internal and external factors influencing study participation.

Conclusion: The MIND-ADMINI was well-tolerated by the participants. At the beginning of the study, the number of tasks and visits was perceived as burdensome but was later well tolerated. The participant' knowledge about AD and prevention increased during the trial. Their motives for participating in MIND-ADMINI were described as both altruistic and self beneficial. Health benefits from the study components, access to specialized medical care were identified as benefits. Managing the intensive flow of information was described a major challenge. The participants' needs for personalized support during the trial stress the importance of applying a person-centered approach providing the preventive trials.

The objective of this paper is to further the understanding of young people's experiences of out-of-home care (OHC). The focus will be on the tension between negative and positive experiences of OHC, refracted through the concept of liminality. The study is based on semi-structured interviews with 10 young people aged 15–22 (7 women, 3 men) with long-term contact with social services and psychiatric care. OHC can be experienced as a liminal space in both a negative and a positive sense. It is negative when perceived as containment rather than meaningful treatment. It can also be a negative experience when connected to fear, a lack of influence, and uncertainty in terms of being in between the social services and psychiatric care. It is positive when it is perceived as a turning point that enables positive change. It is then connected to feelings of meaningfulness, being respected, hope, and empowerment. The young people participating in the study also connect their experiences of OHC to a context of greater austerity in the welfare state. They reflect upon the benfits of OHC in terms of costs for society, but also the costs for the young person if the OHC is not perceived as meaningful support leading towards positive change. The participants have complex, interrelated needs and problems, and they also experience institutional gaps between psychiatric care and social services. It is important to overcome these gaps, so that young people are not located in ‘in-between spaces’ in terms of service provision. 

Research Findings: In Swedish preschools, second-language learners often display lower engagement in activity settings than first-language learners. This study used a multilevel model to examine the association between children’s language status, classroom structure, teacher qualifications, and engagement in preschool activity settings. The sample included 148 children, aged three to five, from classrooms with varying proportions of first and second-language learners. The Child Observation in Preschool (COP) instrument measured engagement levels. Our findings reveal that the presence of highly qualified teachers significantly increased the duration of high engagement for all children, regardless of language status. While second language learners initially appeared to show lower engagement, this difference was insignificant in the full model after accounting for classroom structure and teacher qualifications. Classrooms with a higher proportion of qualified teachers demonstrated improved engagement across the board. Policy and Practice: These findings underscore the importance of ensuring a high proportion of qualified teachers in early childhood education and care settings. Creating a supportive, high-quality educational environment is essential for fostering engagement among all children but may be particularly crucial in classrooms with diverse language backgrounds.

The Swedish preschool curriculum stipulates that all children independent of support needs should attend mainstream preschool groups, with equal opportunities for learning and engagement. Preschool teachers are responsible for paying attention to children in need of special support to achieve this. How support is provided for children in need of special support due to behavior difficulties in Swedish preschools varies, however. Some children, often formally identified as in need of special support, are supported by preschool staff supervised by external services. Other children receive support initiated and implemented by preschool staff, without supervision from external services. A further number of children receive no support for behavior difficulties, on top of what is provided to all children. This study investigated associations between support format (i.e., supervised support, staff-initiated support, or no additional support), support content (i.e., implementation of support), behavior difficulties, socio-demographics and engagement. A mixed methods approach was used with a sample of 232 preschool children 15–71 months with assessed behavior difficulties. Preschool staff reported on the children's engagement, behavior difficulties, socio-demographics, and support provision. Logistic regression models were used to analyze the probability of children receiving either support format. Content analysis was used to categorize the support content, reported by preschool staff through open-ended questions. Point-biserial correlations were used to test associations between support content, behavior, socio-demographics and engagement. All children receiving supervised support for behavior difficulties were formally identified by external services as in need of special support. Supervised support was also more common if children disturbed the free play in the preschool group, with the most frequent support being collaboration with external teams. Staff-initiated support was most commonly given to children with high engagement, and for children who are not early second language learners. These children were most frequently supported by staff paying attention to negative behavior. Children who were not perceived as a burden to the group were less likely to receive any form of additional support. Ways of managing the preschool group seem to guide support strategies for children with behavior difficulties, rather than child-focused strategies emphasizing engagement in everyday activities.

Title: Dementia care and “best practice” - in everyday life until end of life

Background: This study is part of a project financed by Mälardalen Skill Centre for Health and Welfare (MKHV) 2016-2018, aiming at providing practitioners bases to develop evidence based activities in municipal eldercare.

Aim: To search for “best practice” within municipal care for older persons with dementia (PWD), through a knowledge overview.

Methods: Based on a literature review with search words taking a broad view, 36 articles were analyzed and categorized into three areas: 1. End of life care (EOL) 2. Education for staff and 3. Knowledge of caring and interacting from the perspectives of PWD, next of kin, care professionals and management. The results were presented at three seminars for practitioners who were invited to give feedback.

Results: EOL: Findings show diversity between different care professionals, the PWD and next of kin. Care professionals and next of kin seldom regard dementia as the terminal illness it is. This makes the border between everyday life and end of life care blurred which complicates care and interactions. Education: Intervention studies with education program based on a learning philosophy and focusing on communication are promising. Interprofessional education may help staff to think outside the box. When structural reforms are included in interventions there is a potential for lasting change. Knowledge of caring and interacting showed diverse views on therapies, where intentions of therapies may clash with PWD´s perspectives, such as symptom control rather than adding quality of life. Care management assessments risk being discriminatory if PWD are treated as objects. Nuanced examples of life review and validation method challenge routines and show potentials to enrich life and care of PWD.

Conclusions: A broad view on “best practice” informs dementia care with a holistic perspective encompassing art, communication skills, life history, interprofessional cooperation as well as environmental aspects of everyday life until end of life. More participant observation type of studies are welcome to capture the interplay between the actors: older PWD, their next of kin and care professionals. PWD´s voices are crucial to develop best practices.

Introduction Poor mental health in young people has become a growing problem globally over the past decades. However, young people have also been shown to underutilize available healthcare resources. The World Health Organisation (WHO) has formulated guidelines for youth-friendly health services (YFHSs) to increase youth participation in healthcare. Still, little is known about how young people using these services perceive mental health, indicating a knowledge gap concerning the subjective evaluation of their mental health.Aim To investigate how young people visiting youth health clinics (YHC) perceive the concept of mental health and factors they view as central to maintaining mental health.Methods In total 21 interviews were carried out, 16 in 2018, and 5 in 2023 to assure no changes in findings after the COVID-19 pandemic. Subjects were recruited during visits to youth health clinics (YHCs) in mid-Sweden and were aged 15-23 years. Recruitment strived to achieve heterogeneity in the sample concerning gender, sexual orientation, gender identity and age. Interviews were transcribed and analysed using qualitative content analysis.Findings Findings of the analysis revealed two themes, "Mental health is helped and hindered by the surroundings" and "Mental health is difficult to understand and difficult to achieve". The participants described their health as highly dependent on their social surroundings, and that these are important to maintaining health but may also affect health negatively. They described mixed experiences of the health care services and mentioned prerequisites for seeking care for mental health problems such as accessibility and respect for their integrity, including the right to turn down offered treatment. The informants also viewed mental health as an ongoing undertaking that one must work for, and that it is sometimes difficult to know what constitutes mental health. They also expressed a need from healthcare services to enquire about their health, and to show an active interest in how they are doing.Conclusions Findings underline the need of young people's individual needs to be met in the healthcare system and their vulnerability to their social surroundings. Health status assessments in young people should consider social and individual factors to fully capture mental health.

AimThe aim of the study was to explore meaningful everyday life situations as perceived by six-year-old children born preterm. Materials and methodsThe study had a descriptive qualitative design with an inductive approach. Ten, six-year-old children born preterm, not diagnosed with any disabilities, participated. Data was collected by photo-elicitation interviews to stimulate and help the children to describe their meaningful everyday life situations. A qualitative content analysis according to Elo and Kyngas was applied. ResultsThe children's descriptions of meaningful everyday life situations can be understood as being in an active and dynamic process, representing the core category. The analysis resulted in three generic categories, as the children described the significance of having significant circumstances and doing things. The experiences the children gain when they do things create their desire for further development. DiscussionThe results reveal that children born preterm are able to reflect on and give detailed descriptions of situations of importance to them. The study suggests that if six-year-old children born preterm are given the opportunity to share their views they can take an active role e.g. in planning and carrying through of interventions by health care services.

Allt fler upplever utmaningar med sin psykiska hälsa, negativa tankemönster, ångest och depressiva tillstånd. Studiens syfte var att belysa vilken inverkan tankar kan ha på individens psykiska välbefinnande samt vilka metoder som upplevs hjälpsamma för att förändra dysfunktionella tankemönster. Studien hade en kvalitativ induktiv ansats där semistrukturerade intervjuer genomfördes med åtta respondenter. Intervjuerna bearbetades med en tematisk analys som sedan sammanfattades genom fem teman. Resultatet visade att respondenterna upplevde att tankar har en stark inverkan på det psykiska välbefinnandet. Deltagarna beskrev att kognitiv beteendeterapi i form av att träna in funktionella tankemönster, skifte av fokus, hälsofrämjande beteenden, mer närvaro och släppa kontroll och stanna kvar upplevdes betydelsefulla för deras psykiska hälsa. Resultatet visade även att deltagarna upplevde det hjälpsamt att både förändra tanken i sig, att ändra hur individen förhåller sig till sina tankar samt att införa hälsobeteenden som minskade mängden negativa tankar. 

Public spaces are often failing girls and women, with male dominance and a lack of representation being prevalent issues. The 2030 Agenda emphasises the need for safe and accessible public spaces for women, children and other disadvantaged or marginalised  groups. Nevertheless, women and girls tend to be neglected in the development of urban areas, and their specific needs and risks are not fully considered. Hence, there is a need for feminist urban planning.  Feminist planning aims to understand, challenge, and change power relations in public spaces, by involving the experiences, needs, and desires of marginalised groups in the planning process in order to create more equal cities. This approach recognises the individual and collective power that women and other disadvantaged groups already possess. Social innovation is an innovative practice for meeting social needs and shares a common goal with feminist planning of promoting social change and increasing power for disadvantaged groups. However, whereas feminist urban planning – and urban planning in general – tend to end when a project has been planned and executed, social innovation has a stronger and more explicit focus on results or impact of the process or project. This is an aspect where feminist planning can learn from social innovation. By addressing the specific needs of marginalised groups and focusing on results and actual change, feminist planning can contribute to positive social change and empower women and girls in urban development processes. This viewpoint argues that feminist planning can learn from the focus of social innovation on results (i.e. output, outcome and impact of the planning), which has the potential to change planning practices and challenge gendered social norms in order to create more equal, just and socially sustainable public spaces and cities.

AimTo investigate strategies used by professionals in pediatric rehabilitation to engage children in every step of the intervention process, including assessment, goal setting, planning and implementation of the intervention, and results evaluation.MethodsA scoping literature review was conducted, and seven databases were searched, including CINAHL and MEDLINE, ProQuest Central, PsycINFO, Social Science Premium Collection, PubMed, and Web of Science. A citation search of included articles was completed. Predetermined criteria, quality standards, and PIO framework guided the selection process. Results were presented in relation to Self-Determination Theory (SDT) and the contextual model of therapeutic change.ResultsIn total, 20 studies were included in the review. Pediatric professionals reported that therapeutic use of self and their own engagement in the intervention facilitated the establishment of a supportive relationship. Providing clear explanations about their role and therapy rationale developed positive expectations. By making the child feel successful within-session and outside-session activities, professionals enhanced child mastery. Professionals' strategies were abstractly described.ConclusionsFurther research is needed to investigate strategies that are effective in the different steps of the intervention. More observational, longitudinal studies are required to capture fluctuations in in-session engagement.

Background In Sweden, antenatal and child health care are offered free of charge to all expectant and new parents. Professionals in antenatal and child health care play an important role in supporting parents. Previous research shows that same-sex mothers face heteronormative assumptions and insufficient support during their transition to parenthood. Objective To explore professionals' experiences of supporting two-mother families in antenatal and child health care. Method A qualitative method with focus group discussions was used. An interview guide was followed, and the discussions were held online. The data was analysed according to inductive content analysis. Settings and participants The participants were midwives (n = 8) and nurses (n = 5) in antenatal and child health care from different parts of Sweden. Participants were recruited through the coordinating midwives and child health care nurses in the different regions. Findings One main category was identified: Striving to be open-minded in supporting same-sex mothers. Health care professionals described meeting well-prepared mothers, with an equal commitment between each other, and mothers on guard against heteronormative views. Professionals provided support through empowerment by creating a safe environment and aiming at providing equal support to all parents or tailored support to same-sex mothers. Mothers described handling challenges, as a balancing act to acknowledge both mothers. Struggling with documents and communication and a lack of information were other challenges to be handled. Professionals reflected on their own professional competence and expressed that knowledge acquired through education, experience and personal interest all contributed to their competence. Conclusions Forms and documentation need to be updated to be gender neutral to be including to a variety of family constelleations. Health care professionals need time to reflect on norms and challenges to better support both mothers in a two-mother family.

BackgroundBecoming a parent can be challenging. Becoming a parent for the first time during the COVID-19 pandemic might pose additional challenges, as the pandemic has imposed restrictions on society, thus affecting parental support. There were changes in parental support from child health services and preschools available for all children and their parents, so called open preschools, have been closed. This study explored first-time parents' experiences of the parental support they received during the COVID-19 pandemic.MethodsA qualitative study involving individual semi-structured interviews with nine first-time mothers who had been on parental leave during the pandemic was conducted. Data were analyzed with inductive content analysis and the results are presented in a main category with three generic categories.ResultsThe main category is entitled, A gap between the needs of parental support and the support provided, and it encompasses three generic categories: The first category, Formal support, refers to support from child health nurses and open preschools. The second category, Lack of formal support, encompasses the lack of person-centred support and lack of parental groups. The third category, Informal support, encompasses support from family, friends, and social media.ConclusionsThe findings indicate that under the restrictions imposed by the pandemic, first-time mothers expressed the need for person-centred support to both parents which will ensure that all parents get the support they expect and need. The participants also expressed a desire for adapted parental groups that are feasible despite the restrictions to allow them to connect with other parents and build networks.

Falls remain the second leading cause of injury-related deaths worldwide; therefore, longstanding practical fall-prevention efforts are needed. Falls can also lead to a reduction in independence and quality of life among older adults. Fall-prevention research has found that early prevention promotes a prolonged independence. However, it remains unknown which intervention is most beneficial for early prevention and how these interventions should be implemented for long-term effects. In addition, the present and future burden on social and healthcare services contributes to a gap in needs and requires an evidence-based fall prevention. Research suggests that strength, balance, and functional training are effective in reducing falls and fall-related injuries. Such training could greatly impacting independence. Fear of falling and strategies for managing falls are the suggested components to be included when evaluating fall-prevention programs. Thus, the preservation of physical functions is highly relevant for both independence and quality of life. It also contributes to psychological and social well-being, which are important factors for enabling individuals to stay at home for as long as possible. To meet future challenges associated with the expected increase in the older population, older adults should be viewed as a golden resource. With assistance from professionals and researchers, they can learn and gain the ability to institute fall-prevention programs in their own environments. These environments are primarily beyond the responsibilities of the healthcare sector. Therefore, programs comprising current knowledge about fall prevention should be developed, evaluated, and implemented with older adults by using a “train-The-trainer” approach, where a natural collaboration is established between civil society and/or volunteers, healthcare professionals, and researchers. For sustainable and effective fall-prevention programs, a co-design and early collaborative approach should be used in the natural environment, before social and healthcare services are required.

This study investigated whether strength, balance, body mass index, falls self-efficacy, activity levels, self-rated health, and participation in a multicomponent exercise intervention could predict physical activity levels after 5 months of self-quarantine due to the COVID-19 pandemic. This study included baseline data of 200 community-dwelling older adults (79% women, 21% men) with a mean age of 72 years who participated in a randomized controlled trial investigating a multicomponent exercise program, with 7-month follow-up survey data of their physical activity levels. The results showed significant associations with the activity levels at the 7-month follow-up. The activity levels (odds ratio (OR): 2.83, 95% CI: 1.20–6.71), the self-rated health score (2.80, 1.42–5.53), and being allocated to a specific multicomponent group-based exercise program (2.04, 1.04–4.00) showed a significant association with the activity habits at the 7-month follow-up. As this study suggests, besides the physical activity levels and the self-rated health score, participation in a high challenge multicomponent exercise program was significantly associated with physical activity levels at the 7-month follow-up. This study indicates that a relatively short multicomponent group exercise program (6–9 weeks) can motivate individuals to sustain their own training and activity levels even several months after the program has been paused or terminated. Identifying older adults’ physical activity levels and self-rated health scores and prescribing multicomponent group-based exercise programs to promote sustained physical activity habits may be a successful alternative to provide for older adults in the future. 

This series of studies examined resilience among nursing students in the context of clinical education in Thailand. Using both quantitative and qualitative methods, this study explored factors associated with resilience, experiences of challenges and support, and strategies for promoting resilience from the perspectives of both nursing students and instructors.

To examine empirical research on resilience among nursing students in the context of nursing education, an integrative review in which the existing literature on nursing student resilience was synthesized in Study I. Key themes around the conceptualization of resilience, factors affecting resilience, and its mediating role in student well-being were identified. To investigate the relationship between nursing students’ resilience and relevant variables in the context of clinical education, a cross-sectional study of 319 Thai nursing students was conducted in Study II. The results indicated that social support, self-directed learning, and perceived stress were significantly associated with resilience levels during clinical education.  

Moreover, to describe nursing students’ experiences regarding challenges and support for resilience within the context of clinical education, in-depth interviews with 28 nursing students were conducted in Study III. The results revealed two main themes regarding nursing students’ experiences of resilience during clinical practice: “experiences of vulnerability” and “experiences of meaningfulness.” The students described challenges in navigating uncertainty, transcending professional struggles, and adapting to diverse clinical encounters. However, they also found meaning through social connections and engaging in positive transformation as key support strategies.

To explore nursing instructors’ experiences with challenges and support strategies to promote resilience among nursing students during clinical education, focus group interviews with 27 nursing instructors were conducted in Study IV. The results highlighted themes around challenges and support strategies for fostering student resilience. The instructors emphasized difficulties in bridging theory and practice, building clinical confidence, adapting to new environments, and managing expectations. They described strategies such as providing thorough preparation, facilitating peer support, and utilizing reflective activities to enhance resilience.

Across the studies, resilience emerged as a crucial quality for nursing students to develop during clinical education. It was conceptualized as a dynamic process influenced by personal attributes, social support, and environmental factors. The research highlighted the complex interplay between challenges that test resilience and strategies that can strengthen it. The findings align with the Unitary Caring Science Resilience Model, which emphasizes caring relationships, holistic well-being, and reflective practice.

Recommendations include integrating resilience building into nursing curricula, implementing comprehensive student support systems, enhancing instructor training, and further research on targeted interventions. These studies underscore the need for a holistic approach to nursing education that fosters clinical competence and resilience. Nursing instructors can better prepare students to thrive amid the complexities of healthcare environments by addressing challenges and leveraging the support strategies identified.

This study contributes fundamental insight into promoting resilience among nursing students in Thailand, with implications for nursing education globally. Further studies could explore cultural factors, evaluate specific interventions, and examine the long-term effects on nursing careers and patient care.

This integrative review aimed to examine empirical research on resilience among nursing students in the context of nursing education. Resilience helps nursing students handle challenges, such as changing learning styles and experiencing their first clinical practice.DesignAn integrative review.MethodsThe search terms focused on resilience and health in nursing students and nursing education. The database used in this review were CINAHL Plus, PubMed and MEDLINE. The Mixed Methods Appraisal Tool appraised the studies' quality.

ResultsThis study explored 52 records and revealed three current research focuses related to nursing students' resilience: (1) the concept and description of resilience, (2) the characteristics affecting resilience and (3) the mediating role of resilience in maintaining holistic health. Recommendations include adding a resilience topic to the nursing curriculum, providing resilience enhancement programs, examining the relationship between resilience and holistic health and exploring the influence of resilience about global health crises.

Public Contribution Resilience among nursing students plays a vital role in helping them to overcome adversities during their nursing education. Additionally, after graduation, nursing students can continue contributing to society as resilient Registered Nurses in the future.

Resilience aids nursing students in dealing with adversities during their nursing education. This study examined the relationship between nursing students’ resilience and relevant variables in the context of clinical education. Methods: A cross-sectional study was conducted to collect data from 319 undergraduate nursing students in Northeast Thailand. The Connor–Davidson Resilience Scale, the Multidimensional Scale of Perceived Social Support, the Learning Experience Scale or the Personal Responsibility Orientation to Self-Direction in Learning Scale, and the Stressors in Nursing Students scale were administered. A multiple regression analysis was performed for factors presumed to be associated with resilience. Results reported that Thai nursing students’ average resilience score was 71.79 ± 16.33. Multiple regression analysis indicated factors associated with resilience, in which social support (β = 0.354, p < 0.001, 95%CI: 0.240 to 0.469) and self-directed learning (β = 0.787, p < 0.001, 95%CI: 0.606 to 0.968) showed a positive association, while stress (β = −0.083, p = 0.025, 95%CI: −0.083 to −0.006) had a negative association. The final model accounted for 43.4% of the variance in the resilience score. In conclusion, self-directed learning, social support, and perceived stress among nursing students during clinical education are associated with their resilience.

Nursing students require resilience to navigate the complexities of clinical practice. This characteristic is essential for managing demanding workloads, unpredictable patient situations, and emotional stressors while maintaining performance and well-being. Fostering resilience helps students develop the capacity to adapt to adversity, overcome setbacks, and remain committed to providing high-quality patient care. This qualitative study explores the challenges and supports influencing nursing students’ resilience during clinical education. Interviews with 28 Thai nursing students revealed two key themes: the “experience of vulnerability” and the “experience of meaningfulness”. The sub-themes of vulnerability included “navigating uncertainty”, “transcending professional struggles”, and “being exposed to diverse encounters”. The sub-themes of meaningfulness focused on restoring strength through social interactions and engaging in positive transformation. This study highlights the need for comprehensive support systems that address personal and professional vulnerabilities. Integrating caring theory principles could further enhance resilience by emphasizing compassionate care and fostering student empathy. This suggests that instructors and stakeholders can significantly impact student well-being by creating supportive environments built on collaboration, empathy, and mentorship, all of which are aligned with caring theory.

This qualitative study explored nursing instructors' experiences in promoting resilience among nursing students during clinical education. Using focus group interviews with 27 instructors from four nursing colleges in Thailand, the study aimed to explore nursing instructors’ experiences of promoting resilience among nursing students during clinical education. Data were analyzed using Braun and Clarke's inductive thematic analysis approach, guided by the Unitary Caring Science Resilience-Building Model. Two main themes emerged: (1) Challenges to Nursing Students' Resilience and (2) Support Strategies for Enhancing Resilience. Challenges included bridging theory and practice, upholding confidence in clinical skills, adapting to new clinical environments, and managing expectations. Support strategies encompassed providing comprehensive preparation, fostering open communication, implementing peer support systems, and utilizing reflective practice. The findings highlight the complex interplay of factors affecting nursing students' resilience and the multifaceted approaches instructors use to support it. The study underscores the need for a holistic approach to nursing education that addresses both clinical competence and psychological well-being. Implications include curriculum redesign to bridge the theory-practice gap, enhanced instructor training in mentorship and resilience-building, implementation of comprehensive student support systems, and integration of technology to support learning and resilience. This research contributes to the understanding of resilience in nursing education and offers insights for developing evidence-based strategies to better prepare future healthcare professionals for the challenges of modern healthcare environments.

This study sheds light on the value systems of the middle-class metropolitan older adults living alone, on the ageing self and the person's relationship to the surrounding society based on eight interviews. Ageing research has emphasized the traditional features of elderly care in India including its collectivist values rooted in filial piety and the extended family as well as embracement of disengagement influenced by the Hindu texts on two phases in later life: "hermit" and "renunciate". Increased social and geographical mobility, however, challenges traditional family systems. Using the example of the urban middle-class older adults living alone, this study explored whether living alone constitutes a challenge to the norms that previous research associated with Indian elderly care. Using abductive phenomenographic analysis the study found that the understandings of older adults in the study show great reflexivity concerning key aspects of their lives. Although the life conditions of older adults living alone deviated in many aspects from dominant traditional norms of filial piety and a care regime based on strong intergenerational interdependence, their responses and reflections mirrored assemblages of values deeply rooted in Hindu Vedic philosophy of the Ashramas and perceptions of independence, autonomy and self-reliance associated with Western "productive" aging.

Background The de-implementation of low-value care (LVC) is important to improving patient and population health, minimizing patient harm and reducing resource waste. However, there is limited knowledge about how the de-implementation of LVC is governed and what challenges might be involved. In this study, we aimed to (1) identify key stakeholders' activities in relation to de-implementing LVC in Sweden at the national governance level and (2) identify challenges involved in the national governance of the de-implementation of LVC. Methods We used a purposeful sampling strategy to identify stakeholders in Sweden having a potential role in governing the de-implementation of LVC at a national level. Twelve informants from nine stakeholder agencies/organizations were recruited using snowball sampling. Semi-structured interviews were conducted, transcribed and analysed using inductive thematic analysis. Results Four potential activities for governing the de-implementation of LVC at a national level were identified: recommendations, health technology assessment, control over pharmaceutical products and a national system for knowledge management. Challenges involved included various vested interests that result in the maintenance of LVC and a low overall priority of working with the de-implementation of LVC compared with the implementation of new evidence. Ambiguous evidence made it difficult to clearly determine whether a practice was LVC. Unclear roles, where none of the stakeholders perceived that they had a formal mandate to govern the de-implementation of LVC, further contributed to the challenges involved in governing that de-implementation. Conclusions Various activities were performed to govern the de-implementation of LVC at a national level in Sweden; however, these were limited and had a lower priority relative to the implementation of new methods. Challenges involved relate to unfavourable change incentives, ambiguous evidence, and unclear roles to govern the de-implementation of LVC. Addressing these challenges could make the national-level governance of de-implementation more systematic and thereby help create favourable conditions for reducing LVC in healthcare.

Purpose: The aim was to culturally validate a questionnaire about children's/youth's participation to be used in a Swedish context. Methods: FUNDES-Child, based on the well-established CASP, was chosen. Questions about engagement and hindering factors were added to the existing questions about frequency and independence in 20 activity areas. Using a qualitative, explorative design, 16 interviews with children/youths/caregivers were made to explore opinions about the questionnaire. Follow-up interviews confirmed the result of the revised questionnaire. Qualitative content analysis was performed. Results: The interviews provided support for the questionnaire's relevance by being a tool to assess important aspects of participation, to gain insights into one's own/the child's participation, and to promote ideas about what causes the degree of participation. To achieve comprehensiveness, no activity area was found to be missing nor superfluous. However, some examples were needed to be modified where "parades" are unusual in Sweden and therefore removed, while "singing in choir" was added. In search for comprehensibility, opinions about the layout of the first version were raised and a varying degree of understanding of wording and concepts were found and thus taken into account. Conclusions: The questionnaire can be used for establishing meaningful goals and to potentially increase children's participation.

The purpose of this study was to compare the effects of two caregiving models on full-term healthy infants' wakefulness, rooting and sucking reflexes, initiation of breastfeeding, and physiological parameters when reunited with their mothers after a mother-infant separation of 130 min after elective cesarean birth.MethodsNinety-five mother-infant pairs participated in a randomized controlled trial, in which full-term healthy infants were allocated to be either dressed in their mothers' arms (n = 56) or skin-to-skin with their mother (n = 39) when reunited with the mother within 130 min after cesarean birth. Data were collected by the Neonatal Behavioral Assessment Scale (NBAS) to assess the infants' wakefulness and prebreastfeeding behaviors. Physiological parameters were assessed at 15 min intervals, from 130 to 205 min after birth. Time to first breastfeed was measured in minutes from the reunion with the mother.ResultsThe primary finding was that physiologic parameters did not differ but time for initiation of breastfeeding after the reunion with the mother was significantly faster in the skin-to-skin group compared to the infants in the mothers' arms group (p = 0.005). Over the full study period, a more relaxed state and drowsy were found in the skin-to-skin group compared to the infants in the mothers' arms group.ConclusionHealthy full-term infants born by elective cesarean, who were cared for by their mothers when reunited within 130 min of separation and cared for by their fathers during the mother-infant separation, initiated breastfeeding successfully and showed stable physiological patterns. Over the observation period, skin-to-skin infants displayed a more relaxed and drowsy state compared to those held dressed in their mothers' arms. There were no significant differences in vital signs between the groups. Infants in the skin-to-skin group initiated breastfeeding significantly faster (p = 0.005) than those in the mothers' arms group.image

Syftet med denna delstudie har varit att undersöka hur initiering och start av utvecklingsarbetet Tillsammans för barnens bästa i Sörmland har gått till. Fokus har varit på generella reflektioner om initiering och start av utvecklingsarbetet som process; framgångar, risker och hinder i utvecklingsarbetet hittills, samt förbättringsmöjligheter för det fortsatta utvecklingsarbetet.

Utvecklingsarbetets egen dokumentation och självrapporteringar, observationer vid gemensamma möten under utvecklingsarbetet samt intervjuer utgör de grundläggande källorna för datainsamling. Intervjupersoner valdes utifrån deras involvering under initieringen och starten av utvecklingsarbetet. En fokusgruppsintervju med elva deltagare gjordes inom ramen för Lärande workshop 1 i slutet av mars 2022 och två kompletterande skriftliga intervjuer gjordes efter fokusgruppsintervjun. 

Utvecklingsarbetet hade inte en enda startpunkt, eller ett specifikt problem att utgå från. Gemensamt i beskrivningar av startpunkter är att flera parter delar en upplevelse av att något behöver göras tillsammans för barns fysiska och psykiska hälsa samt att Skottlandsmodellen lyfts som en intressant utgångspunkt. En upplevd framgångsfaktor är denna delade övertygelse om att länet behöver utvecklingsarbete för att förbättra barns mående. Det finns ett engagemang hos både politiker och tjänstemän. En annan framgångsfaktor är skolans delaktighet i styrningen av arbetet. Intervjupersonerna uttryckte även att det hade varit en lyckad rekrytering av processledare, både utifrån kompletterade kompetenser och framåtdriv. Under uppstartsfasen upplevdes att fokus var på effektmål snarare än projektmål. Intervjupersonerna lyfter detta som en dubbel risk, både att det kan forma/förskjuta förväntningarna på vad projektet kommer att uppnå och att tiden för konkret arbete blir kortare. Även omsättning i personal och chefsnivå ses som en risk. I intervjuerna lyfts även förslag till det kommande arbetet. Att arbeta aktivt med informationsspridning och att arbeta praktiskt tillsammans med hjälp av ”case”, samt att komma i gång med pilotverksamhet bedöms som viktiga framåtriktade aktiviteter. 

Upplevelser och erfarenheter av processen från och med initiering till start och fastställande av projektplan visar många lärdomar för att upprätthålla och främja framgångar, förebygga risker och hinder, samt att sätta i gång förbättringar i det fortsatt utvecklingsarbetet. En generell rekommendation är att identifierade framgångar, risker/hinder och förbättringsförslag tas som utgångspunkt för förbättringsarbetet i fortsättningen. Några övergripande rekommendationer:

1. Att ha mer fokus på projektets målsättningar 

2. Tydlig och enhetlig informationsspridning till, och förankring hos, berörda aktörer och verksamheter. Nyhetsbrevet kan behöva kompletteras med exempelvis dialogträffar, workshops eller liknande.   

3. Eftersom det finns andra aktörer som inte är representerade i styrgruppen rekommenderas att mer dialog förs med dessa aktörer.

4. Case som ett förslag på metod för att synliggöra olika förståelser för vad utvecklingsarbetet skulle innebära för olika parter i samverkan

5. Kartläggning om vad som fungerar bra och mindre bra i fråga om inkludering av berörda aktörer och att ett förbättringsarbete inleds med bland annat mer involvering av barn och vårdnadshavare.

This study explores social workers' perspectives on motivation and receptiveness among clients with norm-breaking behaviors within social services. The aim is to understand how social workers perceive and manage client motivation and how they engage clients in the process of change, especially when the clients themselves lack motivation. Through semistructured interviews with five social workers, their views and strategies were examined and analyzed using thematic analysis. The results show that the social workers' professional discretion and creativity are central to providing effective care despite organizational constraints. Social workers must balance following guidelines with meeting client needs, which requires high professional competence and flexibility. The study also emphasizes the importance of organizational support that encourages this professional judgment.

Introduction The ableist rhetoric around sexuality in disability services and beyond can hinder subjective sexual expression and have a powerful impact on health, self-esteem, and everyday life through internalized ableism, structural marginalization, and interpersonal discrimination. The aim of this study was to explore the ableist rhetoric of sexuality and its impacton sexual scripting for people with intellectual disability.

Methods A thematic analysis was carried out on data generated through ethnographic fieldwork at five sheltered accommodations and semi-structured interviews with ten individuals with intellectual disability.

Results The results show that people in Sweden with intellectual disability are desexualized within a moral order that ismaintained in post-institutional social care. Through this moral order, which is deeply embedded in an ableist rhetoric about sexual relationships, sexual scripting for disabled people is constrained both inside post-institutional social care initiatives, and in the broader community of “ableist environments.” In response, disabled people employ various strategies of resistance.

Conclusions A rhetoric of positive sexuality should be a guiding principle for successfully supporting the development of sexual agency on each individual’s own term.

Policy Implications We conclude by encouraging the development of initiatives that will empower and support people with intellectual disability to learn about their sexual rights and to find solutions that allow for development of sexual agencyand subjectivity.

The COVID-19 pandemic has caused radical changes in education, as in everything else, bringing many challenges. Despite all the difficulties, the COVID-19 pandemic has enormous opportunities for online teaching and the use of digital technologies. A comprehensive understanding of this period is needed to investigate these opportunities. Thus, this study aims to explore the academic staff's experiences of online teaching and the use of digital technologies in practical skills-based courses in health care education. This study was conducted at six universities from six countries (Türkiye, Sweden, Finland, Portugal, Latvia, Lithuania). Data were collected between June 17, 2021 and November 30, 2021 via a focus group with an in-depth interview technique. 22 focus group interviews were conducted with a total of 117 participants. Colaizzi's method was used to evaluate the data to discover, comprehend, and define the experiences of academic staff. The analysis of the interview data resulted in 6 themes, 25 subthemes and 56 categories that captured participants' experiences regarding online teaching of practical skills and using digital technologies in health care education. The findings of the study provide crucial information that will help online teaching and digital technology for practical skills be successfully integrated.

Introduction: Risk-allele carriers of a Monoamine oxidase A (MAOA) gene, short-allele (MAOA-S) in males and long-allele (MAOA-L) in females, in the presence of a negative environment, are associated with alcohol misuse. Whether MAOA-S/L alleles also present susceptibility to a positive environment to mitigate the risk of alcohol misuse is unknown. Thus, we assessed the association of the three-way interaction of MAOA, maltreatment, and positive parent-child relationship with alcohol consumption among adolescents. Methods: This prospective study included 1416 adolescents (females: 59.88%) aged 16 ̵ 19 years from Sweden, enrolled in the “Survey of Adolescent Life in Västmanland” in 2012. Adolescents self-reported alcohol consumption, maltreatment by a family (FM) or non-family member (NFM), parent-child relationship, and left saliva for MAOA genotyping. Results and discussion: We observed sex-dependent results. Females carrying MAOA-L with FM or NFM and a good parent-child relationship reported lower alcohol consumption than those with an average or poor parent-child relationship. In males, the interactions were not significant. Results suggest MAOA-L in females, conventionally regarded as a “risk”, is a “plasticity” allele as it is differentially susceptible to negative and positive environments. Results highlight the importance of a good parent-child relationship in mitigating the risk of alcohol misuse in maltreated individuals carrying genetic risk. However, the interactions were not significant after adjusting to several environmental and behavioural covariates, especially parent’s alcohol use, negative parent-child relationship, and nicotine use (smoking and/or snus), suggesting predictor and outcome intersection. Future studies and frameworks for preventive strategies should consider these covariates together with alcohol consumption. More studies with larger sample sizes are needed to replicate the findings.

This study addresses the scarcity of research on health developments in the heterogeneous group of self-employed workers. It aims at understanding typical health progressions in this group and associations with demographic factors, work characteristics, and self-employment decisions. We investigate health profiles based on mental health problems, self-rated health, and work satisfaction, as well as transitions between them in relation to work effort, reward, overcommitment, demographic characteristics, and entrance and exit into self-employment. Using latent transition analysis, we analyzed data from the Swedish Longitudinal Occupational Survey of Health (SLOSH), including data from 593 participants. We identified four distinct, stable health profiles, revealing associations with work effort, reward, overcommitment, and self-employment decisions. No meaningful relations existed for demographic characteristics. Overall, the findings offer a comprehensive perspective on the health dynamics of self-employed individuals, their associations with work characteristics and decisions to enter and exit self-employment.

This study aims to explore how ninth-grade students perceive their school climate and whether they have encountered critical places and situations at school related to gender equality. Participants engaged in interviews focused on their experiences and perceptions of equality within their educational context. The analysis was conducted using Hirdman’s (1988) two-gender model to specifically examine the dichotomies within the school environment as experienced by students. The findings reveal that students of both genders perceive significant inequalities, identifying distinct gender norms and standards for girls and maybe even more rigid situations for boys. Gender-specific norms reported are traditional: boys are driven by masculinity norms and are accordingly characterized as unruly, while girls act as more well-behaved students which most of them are. The results corroborate previous research, indicating that gender inequalities persist and are reinforced by traditional educational practices where gender-specific norms are deeply embedded. This study underscores the ongoing challenges in improving gender equality in educational settings