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  • 1.
    Coyne, Imelda
    et al.
    Trinity Coll Dublin.
    Harder, Maria
    Mälardalen University, School of Health, Care and Social Welfare.
    Children's participation in decision-making: Balancing protection with shared decision-making using a situational perspective2011In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 15, no 4, p. 312-319Article in journal (Refereed)
    Abstract [en]

    Children's participation in decision-making in the health care setting is complex because parents and health professionals tend to take a protective stance towards children to act in their best interest. Children prefer to be protected in some situations and to share decision-making in others. Adults in the health care setting need to consider children as individuals, rather than as a homogenous group, and take into account that a child's competence and preferences will depend on the circumstances in every situation. This article argues for a situational perspective of children's participation to act in the child's best interest and to balance protection with shared decision-making, according to children's rights and desires.

  • 2.
    Golsaeter, Marie
    et al.
    Futurum Acad Hlth & Care Reg Jonkoping Cty, Jonkoping, Sweden.;Jonkoping Univ, Sch Hlth Sci, CHILD Res Grp, Jonkoping, Sweden..
    Johansson, Lars-Olof
    Futurum Acad Hlth & Care Reg Jonkoping Cty, Jonkoping, Sweden..
    Harder, Maria
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    General practitioners' accounts of how to facilitate consultations with toddlers - an interview study2017In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 35, no 1, p. 3-9Article in journal (Refereed)
    Abstract [en]

    Objective: To describe general practitioners' (GPs') accounts of how to facilitate consultations with children aged 1-2 years. Design: A qualitative study based on focus group interviews. Setting and subjects: Five focus group interviews were conducted with a total of 25 GPs at Swedish primary health care (PHC) centres. The GPs regularly invited toddlers to consultations. Result: The GPs' accounts of how to facilitate consultations with toddlers revealed descriptions of making efforts to instil confidence in the situation to enable the consultation. Toddlers in need of health care always visit the GP with adults such as their parents, guardians or other relatives. Therefore, the GP directs efforts towards the adults and the child more or less simultaneously, as they both need to rely on the GP. The GPs describe how they instil confidence in the adults by establishing a mutual understanding that the consultation is necessary to secure the child's health. Regarding the child, the GP instils confidence by establishing a relationship in order to approach the child and accomplish bodily examinations. Conclusion: The result shows that GPs' encounters with children in consultations are two-sided. The GP needs to conduct bodily examinations to secure the child's health and development, but to do so he/she needs to establish purposeful relationships with the adults and the child by instilling confidence. This indicates that establishing relationships in the consultation is significant, and a way to achieve a child-centred consultation.

  • 3.
    Golsäter, Marie
    et al.
    Hälsohögskolan Jönköping, Sweden.
    Enskär, Karin
    Hälsohögskolan Jönköping, Sweden.
    Harder, Maria
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Nurses´encounters with children in child and school health care: negotiated guidance within a given frame2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 3, p. 591-599Article in journal (Refereed)
    Abstract [en]

    Background:Throughout childhood, children take part in health visits according to a health-monitoring programme. The visits are aimed to promote the children’s development and health and to strengthen them to take own responsibility for their health. Nurses’ actions when encountering children at these visits are not explored to any great extent. Exploring nurses’ actions can facilitate their reflections on their actions towards children and thereby promote children’s involvement in such visits. Aim: The aim of this study was to explore nurses’ actions when encountering children at health visits. Method: A qualitative explorative design, based on 30 video recordings of health visits in child and school health care, was used in this study. These visits were ordinary real-life health visits. The data were subjected to qualitative content analysis. The right to conduct video recordings during health visits was approved by appropriate research ethics committees. Results: The findings show that nurses, in order to carry out the health visits, encounter children through negotiated guidance. This guidance is understood as the process through which the nurses reach agreement with the children, and is comprised of directed and pliable strategies. At one moment, the nurse can use a directed strategy to inform the child and at the next moment a pliable strategy to provide the child space within the given frame, the health-monitoring programme. By using these strategies intertwined, the nurse can provide the child space within the given frame and, at the same time, fulfil his/ her responsibility to promote children’s health and development. Conclusion: The results highlight nurses’ challenging and complex assignment of guiding children to promote their engagement in the health visits, thereby enabling the nurses to promote the children’s health and development according to the national health-monitoring programme.

  • 4.
    Harder, Maria
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Kommunikation med barn vid hälsobesök2014In: Kommunikation med barn och unga i vården / [ed] Maja Söderbäck, Stockholm: Liber, 2014Chapter in book (Other academic)
  • 5.
    Harder, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Andersson, Sara
    Golsäter, Marie
    Child healthcare nurses’ encounters with parents whose child is overweight2019In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 39, p. 152-158Article in journal (Refereed)
    Abstract [en]

    Nurses in the Swedish child healthcare system can make a difference by offering support to parents of children who areoverweight or at risk of becoming so. Still, research concerning these nurses’ clinical practice when encountering parents whosechild is overweight is inadequate. The aim of this study was to describe nurses’ clinical practice when encountering parents of anoverweight child. Data were collected through interviews with 10 nurses, and a content analysis approach was used. The nurses’clinical practice is described in relation to Olander’s theory: Individualising actions, Creating a dialogue, Documenting, andFocusing on normality. This study adds knowledge about nurses’ clinical practice in encounters with parents whose child isoverweight. Also, it adds information on how an issue in a specific care situation may contribute to further understanding anduse of an existing theory in caring science.

  • 6.
    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. 

  • 7.
    Harder, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Christensson, Kyllike
    Kvinnor och Barns Hälsa Karolinska Institutet.
    Preschool children's expressions of engagement in Primary Child Health Care2008Conference paper (Refereed)
    Abstract [en]

    Preeschool children’s expressions of engagement in primary child health care

    Children have their right to give their voice and participate in situations which they are engaged in, according to The Convention on the Rights of Child. The aim of this study was to explore and describe 3 year old children’s expressions of engagement during annual child health care visit.

    A qualitative research design with video-observations was used. Twenty-nine 3 year old children’s actions were focused when interplaying with the nurse. A hermeneutic analysis was carried out to grasp the children’s varied expressions.

    The findings demonstrate how 3 year old children, when invited to the health care activity, are preparing themselves to readiness for engagement. They arrange their bodies in different positions, ask questions, seek contact with parent or are absorbed in thoughtfulness. Then the children direct their attention towards the nurse and/or the health care activity with spoken and/or bodily readiness. Children’s engagement occupies the whole body or separate parts of the body. Further, findings demonstrate how bodily expressions replace each other in a rapid process and how the same expressions can have different meaning depending on actual situation. The children’s spoken expressions: strengthen bodily expressions, are responding to nurses’ invitations or are spontaneously conversation.

    This research project will continue to study expressions of engagement and perceived participation of the children at 4 and 5,5 years of age at their annual primary child health care visits. To take preschool children’s engagement in primary child health care settings into consideration can contribute to promote their participation when interacting with the nurse.

     

  • 8.
    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.

  • 9.
    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.

  • 10.
    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

  • 11.
    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.

  • 12.
    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.

  • 13.
    Harder, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Enskar, Karin
    Jönköping Univ, Sweden.
    Golsater, Marie
    Jönköping Cty Council, Jönköping, Sweden.
    Nurses' use of pliable and directed strategies when encountering children in child and school healthcare2017In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 21, no 1, p. 55-64Article in journal (Refereed)
    Abstract [en]

    Nurses in Swedish child and school healthcare need to balance their assignment of promoting children's health and development based on the national health-monitoring programme with their responsibility to consider each child's needs. In this balancing act, they encounter children through directed and pliable strategies to fulfil their professional obligations. The aim of this study was to analyse the extent to which nurses use different strategies when encountering children during their recurrent health visits throughout childhood. A quantitative descriptive content analysis was used to code 30 video recordings displaying nurses' encounters with children (3-16 years of age). A constructed observation protocol was used to identify the codes. The results show that nurses use pliable strategies (58%) and directed strategies (42%) in encounters with children. The action they use the most within the pliable strategy is encouraging (51%), while in the directed strategy, the action they use most is instructing (56%). That they primarily use these opposing actions can be understood as trying to synthesize their twofold assignment. However, they seem to act pliably to be able to fulfil their public function as dictated by the national health-monitoring programme, rather than to meet each child's needs.

  • 14.
    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)
  • 15.
    Harder, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    ENCOUNTERING PARENTS ​IN THE PRIMARY HEALTH CARE CENTRE​ a balancing act between different perspectives and expectations2019Conference paper (Refereed)
    Abstract [en]

    Background: Primary Healthcare Centers (PHC) are the first instance to seek care for patients who are not acutely ill. Children between 0-18 years account for 23 % of all doctor visits at PHC. These children rarely arrive by themselves; they are accompanied by parents or guardians. Thereby the health care professionals (HCP) need to relate to two individuals in the care situation. Parents are a resource for their child, and they should be given the opportunity to participate with the child in caring situations. The care relation influences the outcome of the encounter between parent, child and HCP. Aim: To describe HCP' reflections about the encounters with parents seeking care for their children at the PHC. Method: A qualitative content analysis with inductive approach was used. The analyzed material consists of HCP's reflections derived from a prior research project regarding children's involvement. Results: Encountering parents who seek care for their children at PHC means that HCP's in these care situations balance between different perspectives and expectations. This balance includes reflections that are described as: To have beliefs about parent's perceptions and expectations; To encounter parents and children as a unit and unique individuals and To guide parents. Conclusion: The prerequisite for district nurses to create a caring relationship with parents and children in a care situation involves understanding and encountering parents’ and children’s perspectives. A caring relationship benefits the care situation, the child's health and parent's trust in the HCP's. 

    Keywords Care relation, Health Care Professionals, Parents, Primary Healthcare Center, Qualitative content analysis, Reflections

  • 16.
    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.

  • 17.
    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.

  • 18.
    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.

  • 19.
    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.

  • 20.
    Söderbäck, Maja
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Coyne, Imelda
    Trinity College Dublin, Ireland.
    Harder, Maria
    Mälardalen University, School of Health, Care and Social Welfare.
    The importance of including both a Child perspective and the Child's perspective within Health Care settings to provide truly Child centred care.2011In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 15, no 2, p. 99-106Article in journal (Refereed)
    Abstract [en]

    The UN Convention on the Rights of the Child (1989) asserts the right of every child to self-determination, dignity, respect, non-interference, and the right to make informed decisions. The provision of quality care in health services tailored to children's preferences means that health professionals have a responsibility to ensure children's rights, and that the child is encouraged and enabled to make his or her view known on issues that affect them. This paper will help illuminate and differentiate between a child perspective and the child's perspective in health care settings. The issues are supported with research which illustrates the different perspectives. Both perspectives are required to perceive and encounter children as equal human beings in child-centred health care settings.

  • 21.
    Söderbäck, Maja
    et al.
    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. Karolinska Inst, S-10401 Stockholm, Sweden..
    The Use of Video Technique in Observing Children's Expressions of Actions2010In: International Journal of Qualitative Methods, ISSN 1609-4069, E-ISSN 1609-4069, Vol. 9, no 4, p. 402-402Article in journal (Other academic)
  • 22.
    Söderbäck, Maja
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Harder, maria
    Mälardalen University, School of Health, Care and Social Welfare.
    Golsäter, Marie
    Hälsohögskolan, Jönköping, Sweden.
    Methodological issues when conducting research with children and adolescents: i The use of videotechnique in observing children's expressions of actionsii The use of drawings and pictures as participatory methods to encourage children to tell about their perceptions on a specific theme.iii The use of focusgroup interviews with children and adolescents.2010Conference paper (Refereed)
    Abstract [en]

    Methodological issues when conducting research with children and adolescents

    Maja Söderbäck, Marie Golsäter, Maria Harder,

    CHILD Research Group, Sweden

    This symposium will focus on methodological issues and challenges using different techniques in qualitative research when conducting research with children and adolescents in health care. The session will consist of three linked presentations that:

    1. Provide experiences of using video technique in observing children’s expressions of actions.  
    2. Provide experiences of using participatory methods such as drawings and pictures to encourage children to tell about their perceptions on a specific theme.
    3. Provide experiences from focus group interviews with children and adolescents.

     

    The concluding discussion will focus on methodological issues related to children´s competence to bodily and verbally express their wish, experiences, motivation and feelings, when using these techniques. Also, research findings from these techniques will be discussed. Furthermore, ethical considerations and the researchers’ interpretation of the children´s perspectives are issues demanding reflections.

    i  The use of video technique in observing children’s expressions of actions  

     

    Maja Söderbäck

    School of Health, Care and Social welfare, Mälardalen University, Sweden

    Maria Harder

    School of Health, Care and Social welfare, Mälardalen University and Department of Women’s and Children’s Health, Karolinska Institutet, Sweden

     

    Video technique is found to be useful in qualitative research when the interest is to explore young children’s expressions of actions in situations where they participate as actors with parents and health care professionals. Through this technique the whole situation and the child´s varying and detailed expressions are captured. Thus the use of video provides the opportunity to capture the child’s subjective perspective. The researcher’s role is to be objective and follow the child in the course of the situation without interference.

    Further, the video technique allows the researcher to study a child’s expressions several times during the analysis, and to reflect and validate with co-researchers. However, the interpretation of the children's expressions of actions needs to be guided by the intention to understand the children’s perspectives.

    This presentation will demonstrate issues related to the use of video technique when observing children three to five years of age during health visits in a Primary Child Health Care situation and in a care procedure involving venepuncture. Further, discussion concerning analysis of the gathered data with respect for children´s competence to bodily and verbally express their wish, experiences, motivation and feelings will be brought up.

     

    1. ii.                  The use of drawings and pictures as participatory methods to encourage children to tell about their perceptions on a specific theme

    Maria Harder

    School of Health, Care and Social welfare, Mälardalen University and Department of Women’s and Children’s Health, Karolinska Institutet, Sweden

    Maja Söderbäck

    School of Health, Care and Social welfare, Mälardalen University, Sweden

    The movement from doing research on children to do research with children within the health care area challenges researchers to use participatory methods. The use of drawings and pictures are such participatory methods which allow children to share their perceptions and experiences of a situation. Drawings and pictures are familiar from children’s every-day-lives and suit their competence. Furthermore, the use of drawings and pictures facilitate the interaction between the child and the researcher. To let children make drawings about a specific theme and tell about them announce the children as experts and that their perceptions and experiences are valuable. The use of pictures makes a theme well-defined for the children and will make it easier for them to associate and talk unconstrained. The combination of various participatory methods in one data-collection might contribute to detailed descriptions of children’s perceptions about a phenomenon. This presentation will demonstrate a combination of participatory methods which have contributed to grasp children’s perceptions of various situations as for example going through a vaccination. The presentation will further bring up methodological issues related to the use of participatory methods and the analysis of grasping children’s perceptions with respect to their competence.

     

     

    1. iii.                The use of  focus group interviews with children and adolescents

    Marie Golsäter

    School of Health Sciences, Jönköping University, Sweden.

    Karin Enskär

    School of Health Sciences, Jönköping University, Sweden.

     

    According the Convention on the Rights of the Child, children and adolescents have the right to be heard in matters concerning them. Focus group interviews is a useful way to voice children's and adolescent's perspectives. The interaction that occurs in a focus group can contribute to new dimensions of a topic from the participant’s perspective and contributes to the exploration of perspectives that might remain undetected in one to-one interviews.

    Focus group interviews might also encourage children and adolescents to express their own view instead of answering in a way they believe the interviewer wants them to answer. One disadvantage could be that those not comfortable taking part in groups may choose not to participate or might have no chance to express their experiences.

    This presentation will demonstrate the methodological issues revealed during focus group interviews with children and adolescents regarding their experiences of health and life style dialogues with the school nurse. Issues such as performing focus groups interviews with participants in various age groups, the size of the group and the use of mixed or unisexual groups will be brought up.

     

  • 23.
    Söderbäck, Maja
    et al.
    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.
    Ranheim, Albertine
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Being in care situations with young children presents ambigious challenges.2015In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 0, no 0, p. 1-6Article in journal (Refereed)
  • 24.
    Wahlström, Emmie
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Golsäter, Marie
    Region Jönköpings län.
    Harder, Maria
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    The same but different: School nurses descriptions of preparing for health visits with children of foreign origin2019In: Advances in health care sciences conference 2019, Karoliska Institutet, Stockholm, november 13-14, 2019., 2019Conference paper (Refereed)
  • 25.
    Wahlström, Emmie
    et al.
    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.
    Granlund, M.
    Jönköping University, Jönköping, Sweden.
    Holmström, Inger K.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Uppsala University, Uppsala, Sweden.
    Peter, Larm
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Golsäter, M.
    Jönköping University, Jönköping, Sweden.
    School nurses' self‐assessed cultural competence when encountering children of foreign origin: A cross‐sectional studyIn: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to investigate associations between school nurses' self-assessed cultural competence in health visits with children of foreign origin and demographic variables, by using a cross-sectional design. A Web-based questionnaire assessing cultural competence and demographic variables was distributed to a nationally representative sample (n = 816) of school nurses in Sweden. Data were analyzed using regression analysis. School nurses assessed themselves as culturally aware and moderately culturally competent, but not as culturally knowledgeable, culturally skilled, or comfortable in cultural encounters. Cultural competence was related to education in cultural diversity, how often nurses encounter children of foreign origin, and nurses' country of origin. In total, these variables explained 23.6% of the variation in school nurses' cultural competence. Because school nurses regard themselves as moderately culturally competent, a foundation for promoting children's health on equal terms in school health care exists. However, education in cultural diversity combined with other additional strategies is needed to further strengthen school nurses' cultural knowledge, skills, and comfort level in encounters with children of foreign origin.

  • 26.
    Wahlström, Emmie
    et al.
    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.
    Granlund, Mats
    Jönköping University.
    Holmström, Inger K.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Uppsala universitet.
    Peter, Larm
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Golsäter, Marie
    Region Jönköping, Sweden.
    How culturally competent are Swedish school nurses? Relations between school nurses self-assessed cultural competence and demographic variables when encountering children of foreign origin2019In: School nurses international, Stockholm, Sweden, 2019Conference paper (Refereed)
1 - 26 of 26
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