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  • 1.
    Bogg, Lennart
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Tillgren, Per
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Thailand and Sweden as welfare regimes: examples from the healthcare sector2014Conference paper (Refereed)
    Abstract [en]

    The characteristics of a welfare state is largely related to social justice and welfare reforms. This is mainly in the form of legislation, economic transfers and services that help to ensure that all citizens receive a basic economic security and access to services such as health care and nursing. A key factor for this is a country's economy and political will. In Thailand, there was a strong economic growth during the 1970s. The corresponding development in Sweden took place in the mid 1940's. Health and welfare is the main area of collaboration between the Ministry of Health in Thailand and Mälardalen University. The aim of this study is from a welfare perspective, a comparison of the similarities and differences in the basic elements of the health care systems in Thailand and Sweden.

    The study is based on analysis of national policy documents from Thailand and Sweden as well as from United Nations Agency.

    Both countries emphasize health and welfare from a social rights perspective in constitutions and other laws. E.g. the Thailand Constitution of 2007 states that a person shall enjoy an equal right to receive standard public health service, and the indigent shall have the right to receive free medical treatment from State's infirmary. The Swedish Constitution recognizes that the personal, economic and cultural welfare should be the fundamental goal of public activity through, among other things promote social care and social security, and good conditions for health. In the Swedish Health Care Act of 1982, the goal is a good health and care on equal terms for the entire population.

    Both Thailand and Sweden have a national system of Universal Health Coverage (UHC), which is defined according to World Health Organization (WHO) as ensuring that all people can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.

    In terms of selected indicators shows for the year 2012 that the Total health expenditure (THE) % of Gross Domestic Product (GDP) amounts in Thailand 4% and 10% in Sweden, general government expenditure on health as % of GDP are 3% resp. 8%, prevention and public health services are 9 resp. 4%, physician density per 1,000 population 0.3 resp. 3.9. The proportion of beds at public/private hospitals are 78/21% resp. 99/1%.

    The example from the health care system shows that the two countries have legislation that emphasizes health as a social right and a public financing of health care. In terms of specific indicators, there are wide variations in terms of costs to society and the individual including prevention and public health services, access to doctors and proportion of beds in public and private hospitals.

  • 2.
    Cederbom, Sara
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Older women´s daily rhythm of activities in a supporting environment, Living with persistent musculoskeletal pain.2012Conference paper (Other academic)
  • 3.
    Cederbom, Sara
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    Older Women’s descriptions of how they activate themselves in their everyday living and what will promote their activity abilities.2012Conference paper (Refereed)
  • 4.
    Cederbom, Sara
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    The importance of a daily rhythm in a supportive environment-  promoting ability in daily activities among older women livingalone with chronic pain2014In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, no 24, p. 2050-2058Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to explore how older women living alone with chronic musculoskeletal pain, describe their ability in performing activities in everyday life and what could promote their ability in activities in everyday life as well as their perceived meaning of a changed ability to perform activities in everyday life. Method: Qualitative interviews were conducted with 12 women, and an inductive content analysis was used. Results: The results showed the importance of a daily rhythm of activities. Activities included in the daily rhythm were socializing with family and friends, physical activities, doing own activities as well as activities supported by relatives and the community. The activities described by the women also promoted their ability in activities in everyday life. Other findings were the women's perceived meaning of being independent and maintaining that independency, along with the meaning of accepting and adapting to a changed life situation. Conclusion: This paper concludes that it is important to be sensitive of individual needs regarding the daily rhythm of activities when health-care professionals intervene in the activities in everyday life of older women living alone, promote the women's independency, and enable them to participate in the community. 

  • 5.
    Choowong, Jiraporn
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Minist Publ Hlth, PIHWD, Boromarajonani Coll Nursing Trang, Trang 92000, Thailand..
    Tillgren, Per
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Thai district Leaders' perceptions of managing the direct observation treatment program in Trang Province, Thailand2016In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 16, article id 653Article in journal (Refereed)
    Abstract [en]

    Background: Thailand is 18th out of the 22 countries with the highest tuberculosis (TB) burden. It will be a challenge for Thailand to achieve the UN Millennium Development target for TB, as well as the new WHO targets for eliminating TB by 2035. More knowledge and a new approach are needed to tackle the complex challenges of managing the DOT program in Thailand. Contextual factors strongly influence the local implementation of evidence in practice. Using the PARIHS model, the aim has been to explore district leaders' perceptions of the management of the DOT program in Trang province, Thailand. Methods: A phenomenographic approach was used to explore the perceptions among district DOT program leaders in Trang province. We conducted semi-structured interviews with district leaders responsible for managing the DOT program in five districts. The analysis of the data transcriptions was done by grouping similarities and differences of perceptions, which were constructed in a hierarchical outcome space that shows a set of descriptive categories. Results: The first descriptive category revealed a common perception of the leaders' duty and wish to comply with the NTP guidelines when managing and implementing the DOT program in their districts. More varied perceptions among the leaders concerned how to achieve successful treatment. Other perceptions concerned practical dilemmas, which included fear of infection, mutual distrust, and inadequate knowledge about TB. Further, the leaders perceived a need for improved management practices in implementing the TB guidelines. Conclusion: Using the PARIHS framework to gain a retrospective perspective on the district-level policy implementation of the DOT program and studying the leadership's perceptions about applying the guidelines to practice, has brought new knowledge about management practices. Additional support and resources from the regional level are needed to manage the challenges.

  • 6.
    Choowong, Jiraporn
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Tillgren, Per
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Thai people living with tuberculosis and how they adhere to treatment: A grounded theory study2017In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 19, no 4, p. 436-443Article in journal (Refereed)
    Abstract [en]

    To develop a conceptual framework of adherence to treatment among Thai people living with tuberculosis, a grounded theory approach was used. A purposive sample of 20 Thai people living with tuberculosis, aged from 23 to 85years, was interviewed. From the participants' perspective, a core category of social belonging was highlighted, with three categories of conditions connected: personal barriers, personal resilience, and social facilitation. Personal barriers encompassed fear of stigma, concealing the illness, and lack of knowledge and motivation to complete the treatment regime. Personal resilience encompassed positive thinking and self-awareness. Social facilitation encompassed the ease of access to health services, continuity in the health service's ability to choose a directly-observed therapy observer, and social support. This study contributes a deeper understanding of the perspective of Thai people living with tuberculosis with regards to adherence to tuberculosis treatment. It might improve how local healthcare workers provide tuberculosis care, and inspire them to tailor care to people living with tuberculosis in a local community to increase personal resilience and reduce stigma.

  • 7.
    Couto, Maria Thereza
    et al.
    Karolinska institutet.
    Tillgren, Per
    Mälardalen University, School of Health, Care and Social Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    Drivers' and conductors' views of causes and prevention of workplace violence in the road passenger transport sector in Maputo city, Mozambique2011In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, no 800Article in journal (Refereed)
    Abstract [en]

    Background

    Workplace violence (WPV) is an occupational health hazard in both low and high income countries. To design WPV prevention programs, prior knowledge and understanding of conditions in the targeted population are essential. This study explores and describes the views of drivers and conductors on the causes of WPV and ways of preventing it in the road passenger transport sector in Maputo City, Mozambique.

    Methods

    The design was qualitative. Participants were purposefully selected from among transport workers identified as victims of WPV in an earlier quantitative study, and with six or more years of experience in the transport sector. Data were collected in semi-structured interviews. Seven open questions covered individual views on causes of WPV and its prevention, based on the interviewees' experiences of violence while on duty. Thirty-two transport professionals were interviewed. The data were analyzed by means of qualitative content analysis.

    Results

    The triggers and causes of violence included fare evasion, disputes over revenue owing to owners, alcohol abuse, overcrowded vehicles, and unfair competition for passengers. Failures to meet passenger expectations, e.g. by-passing parts of a bus route or missing stops, were also important. There was disrespect on the part of transport workers, e.g. being rude to passengers and jumping of queues at taxi ranks, and there were also robberies. Proposals for prevention included: training for workers on conflict resolution, and for employers on passenger-transport administration; and, promoting learning among passengers and workers on how to behave when traveling collectively. Regarding control and supervision, there were expressed needs for the recording of mileage, and for the sanctioning of workers who transgress queuing rules at taxi ranks. The police or supervisors should prevent drunken passengers from getting into vehicles, and drivers should refuse to go to dangerous, secluded neighborhoods. Finally, there is a need for an institution to judge alleged cases of employees not handing over demanded revenues to their employer.

    Conclusions

    The causes of WPV lie in problems regarding money, behavior, environment, organization and crime. Suggestions for prevention include education, control to avoid critical situations, and a judicial system to assess malpractices. Further research in the road passenger transport sector in Maputo City, Mozambique and similar settings is warranted.

  • 8.
    Coyne, I.
    et al.
    School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland.
    Holmström, Inger K.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Centeredness in Healthcare: A Concept Synthesis of Family-centered Care, Person-centered Care and Child-centered Care2018In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 42, p. 45-56Article in journal (Refereed)
    Abstract [en]

    Background: Increasingly within healthcare, different kind of ‘centeredness’ are used to denote the focus of care which can create confusion for practitioners. Methods: A concept analysis was undertaken to identify the antecedents, attributes and relationship between family-, person-, and child-centered care. PubMed and CINAHL were searched from 2012 to 2017 and thirty-five papers were reviewed. Results: Both person- and child-centered care are focused on individuals, a symmetric relationship and the tailoring of care to individual needs while family- centered care is focused on the family as a unit of which the child is included. Person-centered care focuses on an adult person with autonomy, while the focus in child-centered care is the individual child as an own actor with rights but still close to a family. Conclusion: It appears at a conceptual level that the concepts of centeredness contain both similarities and differences. Finding ways to structure nursing and focus the care that respects a person's dignity and humanity is essential in healthcare and should be a major goal of health policy and health systems worldwide. Implications: The identification of the antecedents and attributes embedded in the concepts may help raise professionals’ awareness of the different foci and how this will influence one's practice. There is a need to recognize strengths and weaknesses of the centeredness in different settings and environments. Furthermore, it is important to know which approach to apply within different situations so that quality care is enabled for every person, child and family.

  • 9.
    Coyne, Imelda
    et al.
    School of Nursing and Midwifery, Trinity College, Dublin Ireland.
    Hallström, Inger
    Lund university, Lund, Sweden.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Reframing the focus from a Family-centred to a child-centred care approach for children's healthcare2016In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 20, no 4, p. 492-502Article in journal (Refereed)
    Abstract [en]

    In this article, we argue for a conceptual move from family-centred care (FCC) to a child-centred care approach and the implications for clinical nursing practice. Firstly, we argue that the parents and professional dominance constructs an asymmetric relationship towards the child, which may take away the focus from the child; Secondly, we need to renew efforts to promote the fundamental principles of protection, promotion and participation rights for children and young people according to the United Nations Convention on the Rights of the Child declaration and thirdly, we need to strengthen the child’s perspective and to view the child as an agent representing own experiences and wishes to be respected and negotiated.

  • 10.
    Fritz, Johanna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandborgh, Maria
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    The complexity of integrating a behavioral medicine approach into physiotherapy clinical practice2018In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040Article in journal (Refereed)
    Abstract [en]

    Introduction and Aim: The implementation of a behavioral medicine (BM) approach in physiotherapy is challenging, and studies regarding the determinants are sparse. Thus, the aim of this study was to explore determinants of applying a BM approach in physiotherapy for patients with persistent pain across the micro-, meso-, and macro-levels. Methods: A qualitative multiple-case study design was used. Data were collected from four cases through semi-structured interviews with physiotherapists (PTs), patients, and managers; observations of video-recorded treatment sessions; and reviews of local directives and regulations. Data were analyzed with inductive content analysis and cross-case analysis, followed by mapping to the domains of determinants at the micro-, meso-, and macro-levels within the Implementation of Change Model. Results: Similar determinants were found across the cases. At the micro-level, these determinants concerned the PTs’ ambivalence toward a BM approach, a biomedical focus, embarrassment asking about psychosocial factors, BM knowledge, skills for applying the approach, and self-awareness. Others concerned the patients’ role expectations of the PT, patients as active or passive agents in the treatment process, patients’ focus on biomedical aspects, and confidence in the PT. At the meso-level, support from managers and peers, allocation of time, and expectations from the organization were identified as determinants. No determinants were identified at the macro-level. Conclusion: The complexity of integrating a BM approach into physiotherapy clinical practice arises from multiple determinants functioning as both facilitators and barriers. By selecting strategies to address these determinants, the implementation of a BM approach could be supported.

  • 11.
    Hanpatchalyakul, Kulnaree
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Tillgren, Per
    Mälardalen University, School of Health, Care and Social Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    Sitanon, Thongsouy
    Caring for addicted Clients by Swedish Community Social workers, Sweden2012In: Journal of Nursing Science and Health, ISSN 2320-1940, Vol. 35, no 3, p. 107-117Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore and describe the Swedish social workers’ experiences in caring for addicted clients in the middle-sized municipality with a population of about 130,000 inhabitants. Qualitative descriptive study was applied. Purposive sampling was used to recruit the participants. Seven Swedish social workers participated in the study. These participants had extensive experiences and were able to communicate in English. The structured interviews, field notes, and the tape recorder were used during data collection process during February 21 st to March 23rd 2011. Content analysis was used for data analysis. The results disclose that two themes emerged including ways of encountering and ways of caring. The first theme way of encountering, social workers encourage their drug addicted clients to sustain abstinence by using motivation talk and showing respect for human rights. In another theme, way of caring, social workers applied standardize methods in the caring process and collaboration between the health care and social welfare systems.

  • 12.
    Harder, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Christensson, K.
    Karolinska Institutet, Stockholm, Sweden.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Undergoing an immunization is effortlessly, manageable or difficult according to five-year-old children2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 2, p. 268-276Article in journal (Refereed)
    Abstract [en]

    Background: To prevent diseases among children they regularly undergo immunizations. Previous research show different approaches available to facilitate immunization-procedures for children to protect them from harm. To complement this research and provide care suited for children, research recognizing their perceptions of undergoing such a procedure is needed. Aim: The aim of this study was to describe 5-year-old children's perceptions of undergoing an immunization. Method: A phenomenographic approach and analysis was used to describe the children's (n = 21) various perceptions. The data-collection was accomplished directly after the immunization to grasp the children's immediate perceptions. Drawings and reflective talks were used as they are considered as suitable methods when involving young children in research. The right to conduct research with children was approved by the appropriate research ethics committee and also by each child and the parents. Results: The findings show that children's perceptions of an immunization-procedure may vary from effortlessly, to manageable or difficult. Regardless of how the child perceive the immunization-procedure each perception embrace the children's descriptions of actors and articles in the situation, their feelings in the situation and also their actions to deal with the immunization. Nevertheless, these descriptions vary according to how the children perceive the immunization as effortlessly, manageable or difficult. Conclusion: Children's and adults' perceptions of medical procedures may differ and children need guidance, time and space to deal with them. Recognizing children's perceptions of undergoing an immunization contributes to the promotion of their right to be involved in their own health care and towards the development of child-centred care. 

  • 13.
    Harder, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Christensson, Kyllike
    Mälardalen University, School of Health, Care and Social Welfare.
    Coyne, Imelda
    Trinity College Dublin, Ireland.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    Five-year-old Children's Tuning-in and Negotiation Staregies in an Immunization Situation2011In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 21, no 6, p. 818-829Article in journal (Refereed)
    Abstract [en]

    In this article, we have explored 5-year-old children's expressions when they as actors took part in an immunization situation in the Primary Child Health Care (PCHC) service in Sweden. Although children's health and development are the main concern in the PCHC service, their perspectives in such a setting have not been explored fully. To capture children's perspectives we used a hermeneutic design and video observations. The findings revealed children as competent and active participants, contributing to the construction of the PCHC situation in mutuality with the nurse and the parent. The conceptualization of children's expressions and actions revealed how they influenced and dealt with a PCHC situation by using strategies of tuning-in, affirmative negotiation, and delaying negotiation. Understanding children's actions will assist nurses to act with sensitivity when they encounter and support children.

  • 14.
    Harder, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Christensson, Kyllike
    Mälardalen University, School of Health, Care and Social Welfare. Karolinska Institutet, Sweden.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    Exploring three-year-old children in a primary child health care situation2009In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 13, no 4, p. 383-400Article in journal (Refereed)
    Abstract [en]

    In the Swedish Primary Child Health Care (PCHC) children participate in regular health visits. In these visits children as actors demonstrate their subjective maturity through bodily and verbal expressions. The aim of this study was to explore three-year-old children's expressions when they take part as actors in a PCHC situation. An explorative design with a hermeneutic approach and video observations was used. Twenty-nine children participated. The findings exhibit a variation of expressions in the situation conceptualized as actions in a progression of states: from a state of getting ready to a state of being ready and further to a state where the child strengthens their own self. This progression is dynamic and coloured with the states of not being ready or of being adverse. The conceptualization of children's expressions can contribute towards encouraging nurses' sensitivity when inviting and guiding children in PCHC situations.

  • 15.
    Harder, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Christensson, Kyllike
    Kvinnor och barns hälsa, Karolinska Institutet.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    Four year old children's negotiation strategies to influence and deal with a Primary Health Care situation2013In: Children & society, ISSN 0951-0605, E-ISSN 1099-0860, Vol. 27, no 1, p. 35-47Article in journal (Refereed)
    Abstract [en]

    In Sweden, children’s health and development are promoted through Primary Child Health Care (PCHC) visits. The children participate in these visits from their own perspective through bodily and verbal expressions. This study explores four-year-old children’s expressions when they as actors take part in a PCHC situation. The conceptualisation of the children’s expressions reveals various actions that exhibit their affirmative and delaying negotiation strategies to influence and deal with these situations. For PCHC nurses, these findings may encourage to view children as negotiating participants and inspire to sensitivity when inviting children and guiding them through health visits

  • 16.
    Harder, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Christensson, Kyllike
    Kvinnor och Barns Hälsa, Karolinska Institutet.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    Four year old Children’s strategies of negotiation when they are holding a Primary Child Health Care situation2009Conference paper (Refereed)
    Abstract [en]

    Four year old Children’s strategies of negotiation when they are holding a Primary Child Health Care situation

    The Swedish Primary Child Health Care (PCHC) is assigned to promote children’s (age 0-5) health and development through regular health visits. A child’s first year involves several health checkups, then planned health visits take place at 3, 4 and 5,5 years of age. These health visits is a part of a monitory program to examine the child’s speech development, motor and cognitive functions. During the health visit the child and the parent will meet a PCHC nurse. Recently, the child’s perspective as an actor in the health visit was explored. The result demonstrated how three year old children exhibit various actions in a progression of states. The child progress from a state of getting ready to a state of being ready and further to a state where the child strengthens the own self. This progression is dynamic and coloured with the states of not being ready or of being adverse. The aim of present study is to describe the four year old children’s strategies when they are holding a PCHC situation. The study has an explorative design with a hermeneutic approach and video-observations are used. Twenty-nine children participate and the selection is strategically. Informed consent was gained in writing from all children, parents and nurses. The findings exhibit how the children use various strategies of negotiation when they are holding a PCHC situation. Illuminating children’s perspective by conceptualizing their expressions and strategies may contribute towards encouraging the PCHC nurse’s sensitivity when inviting and guiding children in the health visit.

  • 17.
    Harder, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Christensson, Kyllike
    Kvinnor och Barns Hälsa, Karolinska Institutet.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    Preschool children's expression of participation in Primary Child Health Care2008Conference paper (Refereed)
    Abstract [en]

    Preschool children's expression of participation in primary child health care

    Introduction

    According to The Convention on the Rights of Child children have the right to have their voice heard and to participate in situations that involve them.

    Aim of the study

    The aim of this study was to explore and describe the expression of participation of 3-year old children during their annual primary health care visit.

    Methods

    The study employed qualitative research design using video-observation, and focused on the actions of twenty-nine 3-year olds in their interaction with the nurse. The varying expressions of the children were captured using hermeneutic analysis.

    Results

    The findings demonstrate how 3-year old children prepare themselves for particiaption prior to their health care visit. They arrange their bodies in different positions, ask questions, seek contact with their parent or are absorbed in their thoughts. The children then direct their attention towards the health care activity, by using bodily and/or spoken expressions they respond to the nurse´s invitations. When the children have replyed to the invitation they confirm them self. Findings also show children´s expressions of unpreparedness and reluctance in the health care situation.

    Conclusion / discussion

    Children’s participation occupies either all or part of the body and bodily expressions replace each other in a rapid progression. Children´s spoken expression strengthens their bodily expression.

    Practical relevance

    Studying pre-school children’s expressions in the child health care environment can contribute to promote their participation in their interaction with nursing staff.

    Research implications

    This research project will continue by studying the expression of perceived participation of children at 4 and 5,5 years of age during their annual primary health care visit.

    References

    Allmark, P. (2002). The ethics of research with children. Nurse researcher, 10 (2), 7-20.

    Bronfenbrenner, U. (1979). The ecology of Human Development. Cambridge, Mass. Harward university press.

    FA, Ministry for Foreign Affairs, (1989). The Convention on the Rights of the Child.

    Fraser, S., Lewis, V., Ding, S., Kellet, M. & Robinsson, C. (2004). Doing research with children and young people. London: Sage Publications.

    Hammersley, M. & Atkinson, P. (1995). Ethnography. Principles in Practice. London: Routledge

    Ministry for Health and Social Affairs. (2005). Mötet med barnet. Barnkompetens inom hälso-och sjukvården. 2005.031

    National Board of Health and Welfare. (1991). Allmänna råd från socialstyrelsen 1991:8. Hälsoundersökningar inom barnhälsovården. Stockholm: Allmänna förlaget.

    Schutz, A. (1967). The phenomenology of the Social World. Evanston: North-western Univ. Press.

  • 18.
    Harder, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Karolinska Inst, S-10401 Stockholm, Sweden..
    Enskar, Karin
    Jonkoping Univ, Jonkoping, Sweden..
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    The Use of Drawings and Pictures as Participatory Methods to Encourage Children to Tell About Their Perceptions on a Specific Theme2010In: International Journal of Qualitative Methods, ISSN 1609-4069, E-ISSN 1609-4069, Vol. 9, no 4, p. 401-401Article in journal (Other academic)
  • 19.
    Harder, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    Hur uttrycker små barn sin delaktighet vid hälsobesök och i vårdsituationer?2009Conference paper (Refereed)
    Abstract [sv]

    Hur uttrycker små barn sin delaktighet vid hälsobesök och i vårdsituationer?

    Att ha möjlighet att ge uttryck för sitt perspektiv i alla situationer innebär att få vara delaktig vilket hör till ett barns rättigheter. Att fånga barns perspektiv vid ett hälsobesök inom Barnhälsovården eller i en vårdsituation är att ge barnet möjlighet att uttrycka sin kompetens och att göra sin röst hörd. Barn uttrycker sitt perspektiv med kropp (gester, ansiktsuttryck och kroppsrörelser) och röst (tal, ljud). För små barn som ännu inte utvecklat språkets förmåga fullt ut är kroppen viktigt redskap i interaktion med andra. Med sin kropp visar barnet sina intentioner och handlar därefter vilket också påverkar andra i samma situation. Barnets mognad och erfarenheter avgör med vilka uttryck barnet agerar situationsanpassat.

     

    Vi har använt videoobservationer för att upptäcka barns uttryck när de deltar i aktiviteter inom hälsobesök eller i vårdsituationer. Dessa har analyserats för att söka förståelse utifrån barnets perspektiv.

     

    De varierande uttryck som treåriga barn visade i en hälsobesöksituation formade deras handlingar i en progress av olika tillstånd. När barnet inbjuds av sjuksköterskan att delta i en aktivitet rörde det sig från ett tillstånd att göra sig redo, till att vara beredvillig, och vidare till ett tillstånd där det bekräftade sig självt. I denna progress visade sig även tillstånd då barnet inte var redo eller var avogt inställd.

     

    I vårdsituationer med treåriga barn visade barnen uttryck som formade en progress av engagemang på varierande sätt. Efter att ha fått någon form av inbjudan till en aktivitet visade barnen vaksamhet. Denna vaksamhet övergick vidare antingen till ett nyfiket engagemang eller till ett engagemang av följsamhet.  Efter inbjudan och visad vaksamhet med fortsatt misstro mot aktiviteten kunde dock sjuksköterskan och/eller förälder påtvinga barnet till att visa ett motsträvigt engagemang vilket ibland övergick till att barnet visade resignation. 

    Att tydliggöra barns uttryck, handlingar, tillstånd och engagemang i olika situationer inom hälso- och sjukvård kan medverka till att utveckla vårdpersonalens lyhördhet för vad som är barnets perspektiv i sitt arbete för att se till barnets bästa, vilket är intentionen för hur konventionen om barns rättigheter förverkligas och implementeras.

  • 20.
    Harder, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    Using video-technique to capture preschool children's participation2007Conference paper (Refereed)
    Abstract [en]

    USING VIDEO TECHNIQUE TO CAPTURE PRESCHOOL CHILDREN’S PARTICIPATION

    Exploring preschool children’s actions to reveal the way they participate in health care situations is a methodological challenge. This challenge lays in capturing children’s expressions, spoken words and body language. Using video technique during observation offers an opportunity to reveal small changes in children’s expressions that might be failed to secure when using the human eye solely. However, video observation is not only about pushing the ‘rec-button’. It requires both methodological and ethical considerations in advance: What is to be in focus during the video observation? What decides when each observation begins and ends? How much time must be devoted for fieldwork and complementary work? Further, the researcher needs to get informed consent from everyone involved. Constant reflexivity during the initial phase, video observations, transcriptions and analysis is also important as the researcher’s presence will influence the final outcome. When transcribing, the researcher’s predetermined focus guides the selection about what to transcribe. To accomplish a selection when transcribing is necessarily to not get lost in the gathered data. The opportunities to see the same sequence several times and to share the observations with a more experienced researcher can contribute to trustworthiness. Therefore, to describe and discuss video observation as a methodological issue is important. Video observations provide rich and thick information that can bring understanding to children’s participation in a detailed and varied way.

  • 21.
    Harder, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Ranheim, A.
    Department of Nursing, Institute of Neurobiology, Care and Society Karolinska Instiutet, Stockholm, Sweden.
    Health care professionals’ perspective on children’s participation in health care situations: encounters in mutuality and alienation2018In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 13, no 1, article id 1555421Article in journal (Refereed)
    Abstract [en]

    Purpose: Encounters between health care professionals, parents and children in health care services for children are complex as these encounters involve the various perspective and understanding of each person involved. The aim of the study is to describe health care professionals’ understanding of significant encounters with children and parents to uncover the meaning of participation. Method: A qualitative descriptive design was applied. The health care professionals’ narratives (n = 35) of their significant encounters with children were interpreted from the perspective of participation. A phenomenological-hermeneutical approach was used in the analysis. Results: The findings show children’s participation as a dynamic movement in mutuality and alienation which can vary within a situation or between different situations involving the same persons. The movement can occur in mutuality and or in alienation depending on what or towards whom the persons direct themselves. Understanding participation as a movement in health care situations is useful in supporting children’s opportunities to participate from their own perspective and deal with health care examinations. Conclusion: The outcome of a situation can never be predicted. Still, professionals can be aware of their actions in encounters with children.

  • 22.
    Lännerström, Linda
    et al.
    Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University.
    Wallman, Thorne
    Centre for Clinical Research Sörmland, Uppsala University.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    Nurses' experiences of managing sick-listing issues in telephone advisory services at primary health care centres2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 4, p. 857-863Article in journal (Refereed)
    Abstract [en]

    Objective. To describe Swedish nurses’ experience of managing sick-listing issues in telephone advisory services in a primary health care setting.

    Design. The study was a qualitative focus group study.

    Setting. Data collection was conducted in three focus group conversations in a county in central Sweden in 2009. The conversations were recorded, transcribed and analyzed using qualitative content analysis.

    Subjects. The study included fourteen nurses, purposively sampled as having current experience of telephone advisory services at primary health care centers.

    Main outcome measures. How nurses experience and handle sick-listing issues in telephone advisory services.

    Results. Nurses’ management of sick-listing issues was described in three themes: the Nurses Actions which are affected by Enabling conditions and Obstructing conditions. The Nurses’ Actions included making an assessment for appropriate action, making an appointment and/or giving information and guidance to the patient and/or monitoring patient’s rights. Enabling conditions included documentation, routines, supportive co-operation and training in insurance medicine. The obstructing conditions were related to patients’ expectations, co-operation with other professionals, lack of training and the nurses’ professional role.

    Conclusion. The nurses demonstrated difficulties to find themselves as active care-givers in health care of sick-listed patients. They also experienced difficulties due to lack of training and the need to balance demands from the organisation and the patient. By engaging nurses more consciously in the sick-listing process a new perspective will be added in care of sick-listed patients.

  • 23.
    Osman, Fatumo
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    Perceptions of the use of khat among Somali immigrants living in Swedish society2011In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, p. 212-219Article in journal (Refereed)
    Abstract [en]

    Aims: The aim of this study was to gain a better understanding of Somali immigrants’ perceptions of the use of khat living in Swedish society. Using khat is illegal in Sweden

    Methods: A phenomenographic design was used to capture different perception of using khat. Fourteen interviews were conducted with both men and women. The information was subjected to phenomenographic analysis.

    Findings: Perceptions of the habit of chewing khat among Somalis living in Sweden vary. The use of khat is perceived as a kind of food or as a drug. To use khat is perceived as having a physical impact on individual health, as well as an impact on social and family life. Using khat also has an impact on people’s time, because time is needed to indulge the habit. Furthermore, using khat is perceived as a medium for cultural and community cohesiveness. The Somalis prefered preventive measures in place to counter the use of khat in Sweden

    Conclusions: The use of a phenomenographic design which captured the variation in perceptions of the habit of using khat among Somali immigrants’ living in Swedish society is helpful in guiding individual strategies in health promotion activities.

  • 24.
    Quaye Msc, Angela A.
    et al.
    Lund University, Lund, Sweden.
    Coyne, Imelda
    Trinity College Dublin, Dublin, Ireland.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kristensson Hallström, Inger
    Lund University, Lund, Sweden.
    Children's active participation in decision‐making processesduring hospitalisation: An observational study2019In: Journal of cilinical Nursing, ISSN 0962-1067Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: The aim was to explore and describe the child's active participationin daily healthcare practice at children's hospital units in Sweden.Objectives: (a) Identify everyday situations in medical and nursing care that illustratechildren's active participation in decision‐making, (b) identify various ways of activeparticipation, actual and optimal in situations involving decision‐making and (c) explorefactors in nursing and medical care that influence children's active participation indecision‐making.Background: Despite active participation being a fundamental right for children, theyare not always involved in decision‐making processes during their health care. Therestill remains uncertainty on how to support children to actively participate in decisionsconcerning their health care.Design: A qualitative study with overt, nonparticipant observations fulfilling theCOREQ checklist criteria.Methods: Observations of interactions between children aged 2 and 17 years withboth acute and chronic conditions, their parents, and healthcare professionals wereconducted at three paediatric hospitals in Sweden. The Scale of Degrees of SelfDetermination was used to grade identified situations. The scale describes five levelsof active participation, with level one being the least and level five being the mostactive level of participation. Normative judgements were also made.Results: Children's active participation was assessed as being generally at levels fourand five. Children demonstrated both verbal and nonverbal ways of communicationduring decision‐making. Findings indicated that children's, parents' and healthcareprofessional's actions influenced children's active participation in decision‐makingprocesses involving healthcare.Conclusions: Healthcare professionals specialised in paediatrics need to embrace botha child perspective and a child's perspective, plan care incorporating key elements of achild‐centred care approach, to ensure children's active participation at a level of theirchoosing.

  • 25.
    Ranheim, Albertine
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Harder, Maria
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Facilitating young children's participation in health care situations2014Conference paper (Refereed)
    Abstract [en]

    Facilitating young children’s participation in health care situations Background An initiative was given to perform a collaborative research project with health practices in Sörmland on facilitating young children’s participation in health care situations. Departing from workshop with healthcare professionals conveyed that it is an ambiguous challenge to be in care situations with children since each situation depends on its participants; the child, the parents and the professionals. These findings were used in reflective forums to integrate theory and practice to broaden the professionals’ awareness of the child’s perspective in care situations. The project is inspired by a clinical application research (CAR) design, where scientifically trained researchers work with health care professionals, building a team to exchange experiences related to data collection, interpretations and the applicability of the results.

    The use of research involves a process of learning as well as engaging beliefs and actions, and these questions are foundational for the practice of clinical care. Such approach aims at facilitating the use of research in clinical practice, to reduce the eventual gap between theory and its practical application.

     

    The overall aim of the project is to facilitate young children’s participation in their health care situations Method and Material The CAR design involves understanding, interpretation and application. This means reflecting on care situations and being confronted with assumptions from theoretical perspectives as well as training an openness and awareness in caring encounters. The team work is in a continued progress and will last during 2014. The data analysis will then proceed.

    Result :Some preliminary result will be presented about the process and outcome of the clinical application research Clinical implications: This study may contribute to the stock of knowledge regarding the implementation of an interactive communicative device with the purpose to facilitate young children’s participation in their health care situations.

  • 26.
    Rooth, Hetty
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Forinder, U.
    Department of Social Work, Gävle University, Gävle, Sweden.
    Piuva, K.
    Department of Social Work, Stockholm University, Stockholm, Sweden.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    An Assessment of Two Parenting Training Manuals Used in Swedish Parenting Interventions2017In: Children & society, ISSN 0951-0605, E-ISSN 1099-0860, Vol. 31, no 6, p. 510-522Article in journal (Refereed)
    Abstract [en]

    In Sweden, all parents of children aged 0–18 years are entitled to attend free parenting courses as part of a national strategy presented by the Government in 2009. This broad parental support welfare strategy is expected to fulfil the intentions of the UN Convention on the Rights of the Child. In this study, two parenting training manuals were analysed: the Canadian Connect program, based on attachment theory, and the Swedish ABC program, based on social learning theory. The results indicate that the manuals use strategies that can both hinder and support children's rights, regardless of rhetoric of children's best interests. © 2017 John Wiley & Sons Ltd and National Children's Bureau

  • 27.
    Rooth, Hetty
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Forinder, U.
    University of Gävle, Sweden.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Viitasara, E.
    Piuva, K.
    Stockholm University, Stockholm, Sweden .
    Trusted and doubted: Discourses of parenting training in two Swedish official inquiries, 1947 and 20082018In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, no 20_suppl, p. 59-65Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to analyse discourses of parenting training in official inquires in Sweden that explicitly deal with the bringing up of children and parental education and how the representations of the problems and their solutions affect parental subject positions in the early welfare state and at the onset of the 21st century. Method: We carried out a discourse analysis of two public inquiries of 1947 and 2008, drawing on theories about governmentality and power regimes. Tools from political discourse analysis were used to investigate the objectives of political discourse practices. Results: Both inquiries referred to a context of change and new life demands as a problem. Concerning suggestions for solutions, there were discrepancies in parents’ estimated need of expert knowledge and in descriptions of parental capacity. In a discourse of trust and doubt, the parents in 1947 were positioned as trusted welfare partners and secure raisers of future generations, and in 2008, as doubted adults, feared to be faltering in their child-rearing tasks. Conclusions: The analysis revealed how governmental problem descriptions, reasoning about causes and suggestions of solutions influenced parents’ subject positions in a discourse of trust and doubt, and made way for governmental interventions with universal parenting training in the 21st century. 

  • 28.
    Rooth, Hetty
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Forinder, Ulla
    Gävle University.
    Piuva, Katarina
    Stockholm University.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Being a child in the family: Young children describe themselves and their parents who have participated in universal parenting trainingManuscript (preprint) (Other academic)
  • 29.
    Rooth, Hetty
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Piuva, Katarina
    Stockholm Univ, Stockholm, Sweden..
    Forinder, Ulla
    Univ Gavle, Gävle, Sweden..
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Competent parents with natural children: Parent and child identities in manual-based parenting courses in Sweden2018In: Childhood, ISSN 0907-5682, E-ISSN 1461-7013, Vol. 25, no 3, p. 369-384Article in journal (Refereed)
    Abstract [en]

    This article analyses identity constructions in two manual-based universal parenting training programmes in Sweden, Connect (U) and All Children in Focus (ABC). The analysis was performed with discourse analysis of oral messages during parent training courses. The findings revealed that the parents' subject positions altered between troubled and good while the children's subject positions altered between ambiguous and natural in a confessional discourse of uncertainty and competence. Conclusively, pastoral power operated to support parental self-reflexivity and adult control in a process to improve parenting skills.

  • 30.
    Sandberg, Anette
    et al.
    Mälardalen University, School of Education, Culture and Communication. Mälardalen University, School of Education, Culture and Communication, Educational Sciences and Mathematics.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kommunikativ utveckling och miljöns betydelse2014In: Kommunikation med barn och unga i vården / [ed] Maja Söderbäck, Stockholm: Liber, 2014, p. 21-30Chapter in book (Refereed)
  • 31.
    Sandborgh, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Fritz, Johanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    The intention – action gap when using a behavioral medicine approach in physiotherapy for patients with persistent musculoskeletal pain.2017In: World Confederation of Physical Therapy (WCPT) Congress, Cape Town, South Africa, 2-4 July, 2017, 2017Conference paper (Refereed)
  • 32.
    Sitanon, Thongsouy
    et al.
    Phrapokklao Nursing college Chantaburi, BNC Thailand.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Parents health literacy and their experiences of participation in their child's care during hospitalization.2014Conference paper (Refereed)
    Abstract [sv]

     Background. Parents’ health literacy is an important key factor that influences how they are able to understand their child’s health status and needs, and how to participate in the care when their child needs to be in hospital.  Parents are the most important care givers, who facilitate ongoing growth and development of their children, giving protection and support. How well parents are able to care and support their child’s care will be influenced by their health literacy. Further, parents’ experiences of participation in their hospitalized child’s care are not investigated in Thailand, comparing with other international studies.

    The aim. The aim of this study is to explore parents’ health literacy and their experiences of participation in their child’s care during hospitalization.  The study will be conducted in four pediatric units at Phrapokklao Hospital, a central hospital in Chanthaburi, Thailand.

    Method. A descriptive qualitative research design will be used. Thirty biological Thai parents, whose children stay in the pediatric units, will be interviewed. A demographic data sheet will be used to obtain background information on characteristics of the parents.  A semi-structured interview guide with open-ended questions will be used.  The questions include general questions to grasp parents’ health literacy, to specific questions experiences of participation in the child’s care. A content analysis, developed by Graneheim and Lundman, will be used.  Ethical considerations have to be made according to informed consent and voluntarism. Consent is given by the Ethical committee in Chanthaburi Province, Thailand.

    Findings. During the conference preliminary results will be presented as generated concepts of understanding of the Thai parents’ health literacy, as well as generated categories of parents’ experiences of participation in the child’s care.

    Clinical implications. Health literacy and experiences of participation is cultural sensitive. Health care providers in different cultures need to understand parents’ health literacy to develop strategies to facilitate and improve their participation in the care of their children according to the rights in the Child convention.

     

  • 33.
    Stålberg, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandberg, Anette
    Mälardalen University, School of Education, Culture and Communication, Educational Sciences and Mathematics.
    Coyne, Imelda
    Trinity Coll Dublin, Sch Nursing & Midwifery, Dublin, Ireland..
    Larsson, Thomas B
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Using an interactive communication tool in healthcare situations: Patterns in young children's use of participation cues2019In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, article id UNSP 1367493518814928Article in journal (Refereed)
    Abstract [en]

    This study forms part of a larger project about developing and using interactive technology to facilitate young children's participation in healthcare situations. Children's participation in these situations improves their motivation and situated understanding. Likewise, their participation helps professionals to more fully understand the child's perspective. In the project, an interactive communication tool, that is, an application suitable for tablet use, was developed with children, aged three to five, in two clinical settings. When tested, the children's participation cues, identified from video recordings of healthcare situations, were understood as having curious, thoughtful or affirmative meanings. This study aimed to investigate the similarities and differences in the young children's use of participation cues when using an interactive communication tool in healthcare situations. A secondary analysis of the identified cues was performed focusing on age, setting and examination or procedure. In total, 2167 cues were identified representing either curious, thoughtful or affirmative cues. The curious cues were mainly used (66%), followed by thoughtful (28%) and affirmative (6%) cues. Differences in cue usage were seen in relation to the children's age and setting. Knowing how children may react to common healthcare procedures may help increase healthcare professionals' awareness of the need to support children in an individual and situational way.

  • 34.
    Stålberg, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandberg, Anette
    Mälardalen University, School of Education, Culture and Communication, Educational Sciences and Mathematics.
    Coyne, Imelda
    Trinity Coll Dublin, Sch Nursing & Midwifery, Dublin, Ireland..
    Larsson, Thomas
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Using an interactive communication tool in healthcare situations: Patterns in young children's use of participation cues2019In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 23, no 4, p. 613-625, article id UNSP 1367493518814928Article in journal (Refereed)
    Abstract [en]

    This study forms part of a larger project about developing and using interactive technology to facilitate young children's participation in healthcare situations. Children's participation in these situations improves their motivation and situated understanding. Likewise, their participation helps professionals to more fully understand the child's perspective. In the project, an interactive communication tool, that is, an application suitable for tablet use, was developed with children, aged three to five, in two clinical settings. When tested, the children's participation cues, identified from video recordings of healthcare situations, were understood as having curious, thoughtful or affirmative meanings. This study aimed to investigate the similarities and differences in the young children's use of participation cues when using an interactive communication tool in healthcare situations. A secondary analysis of the identified cues was performed focusing on age, setting and examination or procedure. In total, 2167 cues were identified representing either curious, thoughtful or affirmative cues. The curious cues were mainly used (66%), followed by thoughtful (28%) and affirmative (6%) cues. Differences in cue usage were seen in relation to the children's age and setting. Knowing how children may react to common healthcare procedures may help increase healthcare professionals' awareness of the need to support children in an individual and situational way.

  • 35.
    Stålberg, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandberg, Anette
    Mälardalen University, School of Education, Culture and Communication, Educational Sciences and Mathematics.
    Larsson, Thomas B
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Imelda, Coyne
    Trinity College, Dublin, Ireland.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Curious, Thoughtful and Affirmative – Young Children’s Meanings of Participation in Healthcare Situations when using an Interactive Communication Tool2017In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 1-2, p. 235-246Article in journal (Refereed)
  • 36.
    Stålberg, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandberg, Anette
    Mälardalen University, School of Education, Culture and Communication, Educational Sciences and Mathematics.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Child-centred Care: Health Professionals' Perceptions of What Aspects are Meaningful When Using Interactive Technology as a Facilitator in Healthcare Situations2018In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, p. E10-E17Article in journal (Refereed)
    Abstract [en]

    Purpose: A prerequisite for child-centred care is children's participation, which in paediatrics can partly be enhanced by using interactive technology solutions, for instance tablet or smartphone-based applications. These applications, however, mainly target older children. In a research project, a tablet-based application, i.e. a communication tool, was developed, meant to facilitate young children's participation in healthcare situations. This study explored health professionals' perceptions of what aspects are meaningful when jointly using such an application in healthcare situations. 

    Design/Methods: Using the critical incident technique, 18 qualitative, semi-structured interviews focusing on critical incidents were performed with four health professionals who had used the interactive communication tool together with children in various healthcare situations. The data were analysed according to inductive content analysis. 

    Results: Results showed that the health professionals described the use of the tool as meaningful because it provided information that helped the children increase their participation, modify their understanding of the situations, and reduce their fear. The tool was also perceived to contribute to a common language between the children and the professionals, which improved their overall communication. 

    Conclusion: The introduction of an interactive communication tool in healthcare situations seemed to be beneficial for both the children and the health professionals.

    Practice Implications: An interactive communication tool, facilitating both verbal and non-verbal communication, can reinforce children's participation in healthcare situations and contribute to positive outcomes in the childprofessional relationship, as well as in the situation itself. 

  • 37.
    Stålberg, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandberg, Anette
    Mälardalen University, School of Education, Culture and Communication, Educational Sciences and Mathematics.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Younger children's (three to five years) perceptions of being in a health-care situation2016In: Early Child Development and Care, ISSN 0300-4430, E-ISSN 1476-8275, Vol. 186, no 5, p. 832-844Article in journal (Refereed)
    Abstract [en]

    Younger children are common users of health-care services. Their perspective on a health-care situation and their ways of communication differ from that of adults. There is a shortness of research of younger children's perceptions of health-care situations. The knowledge that exists indicates the importance of involving the child's perspective to enable understanding and to offer appropriate support. This paper aimed to describe how younger children perceive to be in a health-care situation. Semi-structured interviews, analysed phenomenographically, were used. The main findings revealed that children view themselves as actors, as either main or co-actors, in a health-care situation. Parents and professionals are also understood as actors. The children's perceptions enable professionals to create a mutual understanding which will give openings for increased involvement of the children and an improved level of the children's health literacy.

  • 38.
    Stålberg, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandberg, Anette
    Mälardalen University, School of Education, Culture and Communication, Educational Sciences and Mathematics.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Larsson, Thomas B
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    The child’s perspective as a guiding principle: Young children as co-designers in the design of an interactive application meant to facilitate participation in healthcare situations2016In: Journal of Biomedical Informatics, ISSN 1532-0464, E-ISSN 1532-0480, Vol. 61, p. 149-158Article in journal (Refereed)
    Abstract [en]

    During the last decade, interactive technology has entered mainstream society. Its many users also include children, even the youngest ones, who use the technology in different situations for both fun and learning. When designing technology for children, it is crucial to involve children in the process in order to arrive at an age-appropriate end product. In this study we describe the specific iterative process by which an interactive application was developed. This application is intended to facilitate young children's, three-to five years old, participation in healthcare situations. We also describe the specific contributions of the children, who tested the prototypes in a preschool, a primary health care clinic and an outpatient unit at a hospital, during the development process. The iterative phases enabled the children to be involved at different stages of the process and to evaluate modifications and improvements made after each prior iteration. The children contributed their own perspectives(the child's perspective) on the usability, content and graphic design of the application, substantially improving the software and resulting in an age-appropriate product.

  • 39.
    Stålberg, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandberg, Anette
    Mälardalen University, School of Education, Culture and Communication, Educational Sciences and Mathematics.
    Young children´s (aged 3-5 years) experiences of being in care procedures including medical investigations2013Conference paper (Refereed)
    Abstract [en]

    Introduction The Convention of children's rights focuses on protection, promotion as well as participation. Research show that young children's active

    participation in matters affecting them is underrated. Further it is known that improving participation in care procedures enhances both motivation and

    engagement. To achieve active participation in care procedures, the variation of experiences and perceptions, need to be explored and described. Purpose To

    explore and describe children's variations of experiences, perceptions, thoughts and wishes in care procedures including a medical investigation. It is a first

    study in a project aiming to develop and test an IT based interactive communication tool (IACT) for younger children. Material Younger children (3-5 years) in a

    preschool, visiting a health care center and a pediatric day care ward. Methods A phenomenographic approach searching the children's variations of

    experiences, perceptions, thoughts and wishes, in verbally and non-verbally expressions. Semi structured interviews, combined with talks based on vignettes,

    observations and drawings are used. Results The result is still preliminary. However the children studied so long describe experiences and thoughts of varied

    content. There are descriptions how they wished the care procedures to be carried out, as well as what scared them and what they wanted to avoid. The

    descriptions of experiences and perceptions will be contrasted and demonstrated in a hierarchy of variations according to a phenomenographic analyses.

    Conclusions The result will be the starting point to develop an IT-based interactive communication tool (IACT) for younger children, aged 3-5, to improve their

    active participation in care procedures based on their experiences, needs and wishes.

     

  • 40.
    Stålberg, Anna
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sandberg, Anette
    Mälardalen University, School of Education, Culture and Communication, Educational Sciences and Mathematics.
    Larsson, Thomas B
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    The child’s perspective as the guiding principle: young children as co-designers of an application used for enabling participation in healthcare situations2016Conference paper (Refereed)
    Abstract [en]

    Introduction: To facilitate child´s rights in healthcare situations, professionals need to be aware of, and use, their child perspective and the child´s perspective in the situation. A child´s rights approach requires that the caring culture and ways of working are adapted to the interactive communication tool, based on children´s perceptions of being in healthcare situations, prerequisites of children.

    Aim: To develop an interactive communication tool, based on children´s perceptions of being in healthcare situations, meant to facilitate children´s participation and understanding in these specific situations.

    Method: Children, 3-5 years, in a preschool, a primary health care clinic and a pediatric outpatient unit at a hospital were encountered in interviews which focused the children´s perceptions of being in healthcare situations. Non-verbal perceptions were elicited through drawings. These perceptions were used in the development of the communication tool. In iterative phases the children, as co-designers, tested and evaluated evolving prototypes of the tool. Their feedback were analyzed and used in the ongoing development and improvement of the prototype.

    Result: an iterative, co-designing process of the interactive communication tool transformed children´s verbal and non-verbal perceptions of being in a healthcare situation into an age appropriate and likeable application regarding content, usability and graphic design.

    Conclusion: an interactive communication tool involving visual guidance of healthcare situations facilitates younger children to elicit their perspective in these situations. Children´s participation in healthcare situations is enabled by professionals who use the child´s perspective, expressed with help of the communication tool, combined with their verbal guidance.

  • 41.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    A Comparative study of Actions and Beliefs involving Family caregivers of hospitalized children among nurses in Sweden and Mozambique2013In: Journal of Cultural Diversity, ISSN 1071-5568, Vol. 20, no 2, p. 66-75Article in journal (Refereed)
    Abstract [en]

    This comparative study of Swedish and Mozambican nurses' beließ and actions in encounters with family caregivers was conducted by analyzing ethnographic fieldwork in pédiatrie hospital settings. The aim was to reveal similarities and diversities in their culturally embedded contexts. A total of 65 nurses were studied working in their daily practice. The analysis was guided by a theoretical framework of actions, such as social modes, and of common thinking in a professional group. The comparative findings, with cultural variations, revealed similarities in the nurses' organizing and demanding actions, as well as diversity in their eliciting actions. The nurses' beliefs concerned types of family caregivers and their activities. The findings refiect the diversity aligned to culturally embedded conditions.

  • 42.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Barn och unga i vårdmiljöer2014In: Kommunikation med barn och unga i vården / [ed] Maja Söderbäck, Stockholm: Liber , 2014, p. 15-20Chapter in book (Other (popular science, discussion, etc.))
  • 43.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    Barnperspektiv eller Barnets perspektiv2010In: Barns och Ungas rätt i vården / [ed] Söderbäck Maja, Stockholm: Allmänna Barnhuset , 2010Chapter in book (Other (popular science, discussion, etc.))
  • 44.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Barns och ungas delaktighet2014In: Kommunikation med barn och unga i vården / [ed] Maja Söderbäck, Stockholm: Liber , 2014, p. 34-44Chapter in book (Other (popular science, discussion, etc.))
  • 45.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    Barns och ungas rätt i vården2010 (ed. 1)Book (Other (popular science, discussion, etc.))
  • 46.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    Empowering skills to improve Family Nursing in Children's care: - Innovation in a global perspective2009Conference paper (Refereed)
    Abstract [en]

    A family interest all over the world is their child’s safety. Family caregivers play a significant role in their child’s recovery. Family involvement has been promoted for decades and been formalized in numerous policy documents. These documents have been embraced by health professionals. Current research demonstrates that nurses find it important to work in trustful relationships with families. Nevertheless, involvement on behalf of a family’s needs and wishes still remains difficult to realize in everyday care. Research demonstrates a discrepancy between what family involvement is supposed to contain and what is actually practiced and experienced by families. Ethnographic research at pediatric wards with different conditions and cultures (Sweden and Mozambique), describe family’s needs and experiences as well as nurses’ beliefs and everyday practice of family involvement. Even though nurses use different tactics or action styles, the dominant process in both Swedish and Mozambican nursing care is a socialization of family caregiver to an expected role on the ward. However, some nurses used skills with empowerment characteristics. The objective is to challenge the skill pool for quality of care in children’s nursing in a global perspective. Different action styles among nurses encountering parents will be described and compared with emphasis on the concept of empowerment and what empowering skills mean in nurses’ actions of family involvement. I will illustrate how involvement and participation is co-created in encounters, in interaction between nurses who use empowering skills and families in need of support. Empowering skills will improve family involvement in children’s nursing.

  • 47.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    Empowerment and empowering skills2008In: NOBAB and EACH conference 12-14 sept 2008 in Helsinki, Finland:: Empowering children and their families in Hospital., 2008Conference paper (Refereed)
  • 48. Söderbäck, Maja
    Encountering Parents: Professional Action Styles among Nurses in Pediatric care1999Doctoral thesis, monograph (Other scientific)
  • 49.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    Ethnographic research to get understanding beyond family involvement of hospitalized children – Sweden and Mozambique2010Conference paper (Refereed)
    Abstract [en]

    Background

    This study assumes that all human interaction is fundamentally social and that nurses, on the basis of their knowledge, organize their professional work and interact in sense that is meaningful to them in different situations. Current research shows that nurses find it important to work in trustful relationships with family caregivers during their child’s hospitalization. Family involvement is formalized according to cultural circumstances that is shaped by community culture, organisational hospital culture, nursing culture and view of generic care captured by traditions in families and a professional view of care learned through nursing training. The social understanding implies that  staff share beliefs and ideas as ‘common thinking,’ which influences the way they act in everyday situations.

    Aim

    To explore nurses’ beliefs and practice regarding family involvement in the care of hospitalised children in Sweden and Mozambique.

    Methods

    Ethnographic fieldwork was used, with a combination of participant observation, reflective talks and interviews. The subjects in Sweden were 30 nurses and in in Mozambique 36 nurses. The observations of each nurse in their daily interaction with family caregivers and their children were followed by an interview. Constant comparative analyses were used to construct themes of action strategies and beliefs.

    Results

    The findings show that nurses’ practice of family involvement reflects the conditions in the society. However there are similarities in nurses’ beliefs and strategies in everyday practice. Even though the nurses use different action styles when encountering family caregivers, the dominant process in both Sweden and Mozambique was a socialization of the family caregivers to an expected role on the hospital ward. However some nurses used skills which revealed empowerment characteristics. The opportunity for nurses to develop culturally congruent family involvement is closely connected to community awareness, nurses’ empowerment and children’s rights.

     

  • 50.
    Söderbäck, Maja
    Mälardalen University, Department of Caring and Public Health Sciences.
    Families Participation in Paediatric care challenge nurses differently – Transcultural studies.2004In: 12th Biennial Conference of the workgroup of European Nurse Researchers. Lissabon, Portugal 5-8 October, 2004Conference paper (Refereed)
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