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  • 1. Birath, Christina Scheffel
    et al.
    DeMarinis, Valerie
    af Klinteberg, Britt
    Stockholm University, Faculty of Social Sciences, Department of Psychology. Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Moods and expectancies of female alcohol drinking - an exploratory study2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 3, p. 472-481Article in journal (Refereed)
    Abstract [en]

    Gaining access to information concerning mood states and expectations of change preceding a typical drinking occasion is important for understanding the trigger factors for drinking, and for alcohol abuse treatment planning. The objective of the present study was twofold: (i) to explore self-reported states of mood and expectancies preceding a typical drinking occasion vs. relations with parents and drinking outcome; and (ii) to investigate if vulnerability factors in terms of personality and health are related to severity of alcohol problems. The population consisted of 50 women attending a Swedish alcohol clinic. Semi-structured interviews were conducted. A mixed-methods design was used encompassing qualitative interview-data and quantitative data from questionnaires and medical journals. Nine out of ten patients had a diagnosis of alcohol dependence, and four out of five had parents with dependency problems. As compared to a female norm group, the patients displayed significantly higher anxiety-related traits and irritability. Moods were described by patients as mostly negative and expectancies of change were evenly distributed between reducing, enhancing or flight from feeling. An expectancy of flight when drinking was also related to a positive relation to mother. The findings pointed to the need for differentiating between coping with and expectancies of drinking. Further, a hierarchical cluster analysis resulted in two groups, indicating one group characterized by higher risk values on personality scales and more severe consequences of drinking. The contribution of a treatment design informed through a gender and culture perspective to treatment outcome was discussed.

  • 2. Daud, Atia
    et al.
    af Klinteberg, Britt
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Rydelius, Per-Anders
    Trauma, PTSD and personality: the relationship between prolonged traumatisation and personality impairment2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 3, p. 331-340Article in journal (Refereed)
    Abstract [en]

    Objective: Chronic post-traumatic stress disorder (PTSD) has been associated with personality impairments involving externalized and internalized psychopathology. This study has explored the association between PTSD symptoms as consequences of prolonged torture experiences or early childhood trauma exposure and personality traits.

    Method: One hundred and sixty-one men were included: 36 Iraqi men refugees (mean age = 43.9, SD = 8.7) who had longstanding torture experiences as adults; 42 Swedish prisoners (mean age = 33.8, SD = 7), with early childhood trauma exposure; 31 Arab men refugees (mean age = 41.8, SD = 8.9) without self-reported torture or violence experiences; 52 non-traumatized Swedish males (mean age = 39.3, SD = 5.5). They were assessed for symptoms of PTSD or PTSD hypothetical clusters. Personality profile was assessed by the Karolinska Scales of Personality (KSP). Factor analysis with varimax rotation was conducted and yielded three factors: externalized, internalized and avoidance domains.

    Results: Individuals who suffered prolonged torture experiences or had early childhood trauma exposure showed impaired personality profiles in internalized and externalized domains. Individuals with or without PTSD showed significant differences p < 0.05 concerning: internalized, externalized and avoidance. anova and post-hoc analysis according to Scheffé showed that the prolonged torture group > early childhood trauma exposure > nontraumatized group.

    Conclusion: Prolonged torture experiences or early trauma exposure may impair personality formation by enhancing the effects of cognitive, affective and behavioural vulnerabilities.

  • 3. Petersson, Lena-Marie
    et al.
    Vaez, Marjan
    Nilsson, Marie I.
    Saboonchi, Fredrik
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden; Red Cross University College, Sweden.
    Alexanderson, Kristina
    Olsson, Mariann
    Wennman-Larsen, Agneta
    Sickness absence following breast cancer surgery: a two-year follow-up cohort study2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 2, p. 715-724Article in journal (Refereed)
    Abstract [en]

    Rationale and aim

    Most women of working ages with limited breast cancer (BC) have returned to work within the first year after diagnosis. However, little is known about what is happening during this year regarding sickness absence and return to work. Also, the knowledge is very limited about the occurrence of part‐time sickness absence after BC diagnosis. Therefore, the aim of this study was to describe occurrence, extent and length of SA during a two‐year follow‐up after BC surgery and to analyse the association between being SA and type of cancer treatment.

    Methods

    In this prospective cohort study, 497 women responded to questionnaires about different aspects of sickness absence at six occasions during two years after primary BC surgery (at baseline and after 4, 8, 12, 18 and 24 months). Treatment information was obtained from the National breast cancer register. Multinomial logistic regression was used to calculate odds ratios (OR) for likelihood of being sickness absent more than once.

    Results

    Two‐thirds of the women were sickness absent at baseline; this proportion decreased, especially during the first eight months. At 24 months, 13% were sickness absent. Of all women, 27% never reported sickness absence and 14% were sickness absent at most of the six survey times. At eight months, many had shifted from full‐ to part‐time sickness absence. Women with chemotherapy and/or advanced BC surgery had higher ORs for being sickness absent at most of the follow‐ups.

    Conclusions

    Most women returned to work within the first eight months after BC surgery and of those sickness absent after that, most had been part‐time sickness absent. Thus, it is important to differentiate between part‐ and full‐time sickness absence in future studies. Special attention should be paid to the impact of chemotherapy and type of surgery on the likelihood of being sickness absent.

  • 4. Ristiniemi, Heli
    et al.
    Perski, Aleksander
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lyskov, Eugene
    Emtner, Margareta
    Hyperventilation and exhaustion syndrome2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 4, p. 657-664Article in journal (Refereed)
    Abstract [en]

    Chronic stress is among the most common diagnoses in Sweden, most commonly in the form of exhaustion syndrome (ICD-10 classification - F43.8). The majority of patients with this syndrome also have disturbed breathing (hyperventilation). The aim of this study was to investigate the association between hyperventilation and exhaustion syndrome. Thirty patients with exhaustion syndrome and 14 healthy subjects were evaluated with the Nijmegen Symptom Questionnaire (NQ). The participants completed questionnaires about exhaustion, mental state, sleep disturbance, pain and quality of life. The evaluation was repeated 4 weeks later, after half of the patients and healthy subjects had engaged in a therapy method called 'Grounding', a physical exercise inspired by African dance. The patients reported significantly higher levels of hyperventilation as compared to the healthy subjects. All patients' average score on NQ was 26.57 ± 10.98, while that of the healthy subjects was 15.14 ± 7.89 (t = -3.48, df = 42, p < 0.001). The NQ scores correlated strongly with two measures of exhaustion (Karolinska Exhaustion Scale KES r = 0.772, p < 0.01; Shirom Melamed Burnout Measure SMBM r = 0.565, p < 0.01), mental status [Hospital Anxiety and Depression Score (HADS) depression r = 0.414, p < 0.01; HADS anxiety r = 0.627, p < 0.01], sleep disturbances (r = -0.514, p < 0.01), pain (r = -.370, p < 0.05) and poor well-being (Medical Outcomes Survey Short Form 36 questionnaire- SR Health r = -0.529, p < 0.05). In the logistic regression analysis, the variance in the scores from NQ were explained to a high degree (R(2)  = 0.752) by scores in KES and HADS. The brief Grounding training contributed to a near significant reduction in hyperventilation (F = 2.521, p < 0.124) and to significant reductions in exhaustion scores and scores of depression and anxiety. The conclusion is that hyperventilation is common in exhaustion syndrome patients and that it can be reduced by systematic physical therapy such as Grounding.

  • 5. Roheger, Mandy
    et al.
    Zupanic, Eva
    Kåreholt, Ingemar
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). Jönköping University, Sweden.
    Religa, Dorota
    Kalbe, Elke
    Eriksdotter, Maria
    Garcia-Ptacek, Sara
    Mortality and nursing home placement of dementia patients in rural and urban areas: a cohort study from the Swedish Dementia Registry2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 4, p. 1308-1313Article in journal (Refereed)
    Abstract [en]

    Background: Life in rural and urban areas differs in regard to social support and health care. Our aim was to examine the association between nursing home placement and survival of patients with dementia living in urban vs. rural areas.

    Methods: We performed a longitudinal cohort study of patients with dementia at time of diagnosis (n = 58 154) and at first follow-up (n = 21 522) including patients registered from 2007 through 2014 in the Swedish Dementia Registry (SveDem). Descriptive statistics are shown. Odds ratios with 95% CI are presented for nursing home placement and hazard ratios for survival analysis.

    Results: In age- and sex-adjusted analyses, patients living in urban areas were more likely to be in nursing homes at the time of dementia diagnosis than patients in rural areas (1.49, 95% CI: 1.29-1.73). However, there were no differences in rural vs urban areas in either survival after dementia diagnosis (urban: 0.99, 0.95-1.04, intermediate: 1.00, 0.96-1.04), or nursing home placement at first follow-up (urban: 1.00, 0.88-1.13; intermediate: 0.95, 0.85-1.06).

    Conclusion: Persons with dementia living in rural areas are less likely to live in a nursing home than their urban counterparts at the time of dementia diagnosis, but these differences disappear by the time of first follow-up. Differences in access to nursing homes between urban and rural settings could explain these findings. Results should be considered in the future healthcare decisions to ensure equality of health care across rural and urban areas.

  • 6.
    Saboonchi, Fredrik
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Red Cross University College, Sweden; Karolinska Institutet, Sweden.
    Perski, Aleksander
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Grossi, Giorgio
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Validation of Karolinska Exhaustion Scale: psychometric properties of a measure of exhaustion syndrome2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 4, p. 1010-1017Article in journal (Refereed)
    Abstract [en]

    Background The syndrome of exhaustion is currently a medical diagnosis in Sweden. The description of the syndrome largely corresponds to the suggested core component of burnout, that is exhaustion. Karolinska Exhaustion Scale (KES) has been constructed to provide specific assessment of exhaustion in clinical and research settings.

    Aim The purpose of the present study was to examine the psychometric properties of this scale in its original and revised versions by examining the factorial structure and measures of convergent and discriminant validity.

    Methods Data gathered from two independent samples (n1 = 358 & n2 = 403) consisting of patients diagnosed with 'reaction to severe stress, and adjustment disorder' were subjected to confirmatory factor analysis. The study's instruments were Karolinska Exhaustion Scale and Shirom Melam Burnout Measure. Correlation analyses were employed to follow up the established factorial structure of the scale. The study was ethically approved by Karolinska Institute regional ethic committee.

    Results The findings demonstrated adequate fit of the data to the measurement model provided by the revised version of KES Limitations: The main limitation of the present study is the lack of a gold standard of exhaustion for direct comparison with KES. (KES-26) and partially supported convergent validity and discriminant validity of the scale.

    Conclusion The demonstrated psychometric properties of KES-26 indicate sound construct validity for this scale encouraging use of this scale in assessment of exhaustion. The factorial structure of KES-26 may also be used to provide information concerning possible different clinical profiles.

  • 7.
    Schön, Ulla-Karin
    Stockholm University, Faculty of Social Sciences, Department of Social Work.
    Recovery from mental illness, a gender perspective2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 3, p. 557-564Article in journal (Refereed)
    Abstract [en]

    Background and research objectives: Recovery from mental illness is an individual process characterized by regaining a positive sense of self and developing a new meaning. Knowledge concerning differences between male and female recovery processes is, however, limited. The objective of this study was to determine gender diversity in what individuals described as decisive factors for their recovery.

     

    Subjects and methods:  In this qualitative study based on grounded theory 30 first-person accounts of recovery from mental illness are examined. After informed consent data were collected through in-depth interviews with people in recovery from psychosis, bipolar disorders or personality disorders.

     

    Results: The results show that in spite of structural gender inequalities, female gender norms seem to be an advantage in the recovery process. The female participants were focused on making sense and meaning in their recovery process, while the male participants were focused on control over symptoms and reinforcement of traditional roles such as occupation and independence. Another result showed psychiatric hospitalization to mainly contribute to male recovery processes.

     

    Conclusion: These results provide new insights into gender as an important factor in understanding recovery processes and in providing care to facilitate these processes.

  • 8. Sigurdardottir, Sigurveig H
    et al.
    Kåreholt, Ingemar
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Informal and formal care of older people in Iceland.2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 4, p. 802-11Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Even if older people in the Nordic countries living in their homes usually have good access to formal help, the family plays an important role. Few studies have looked at the distribution of informal and formal care and the interplay between these spheres. The aim of this study is to shed light on the distribution of care and to analyse the patterns of care depending on the degree of limitations, the gender of the recipient and whether she/he is cohabitating or not.

    METHOD AND SAMPLE: The Icelandic survey 'Icelandic Older People' (ICEOLD) is a random nationally representative survey among persons 65+ living in their homes. Of those who participated (n = 782), 341 were men and 441 were women, giving a response rate of 66%.

    FINDINGS: About 60% of the people investigated in the survey had limitations with instrumental activities of daily living (IADL), and 10% of people had limitations with personal activities of daily living (PADL). The majority of the respondents with IADL or PADL limitations received either informal or formal help, but not both. When the IADL limitations increase, the informal care increases for men, but not for women, and the formal care increases for women, but decreases for men. Cohabiting men are much likelier to receive informal IADL help and less likely to receive formal help than men not cohabiting. Among women, corresponding differences are much smaller and not significant. When there is no spouse, the daughters help more than the sons and they help their mothers more than they help their fathers.

    CONCLUSION: More persons receive informal care than formal care, which shows the importance of the family. There is a gender difference in receiving care. Cohabitation is important for receiving informal care, especially for men.

  • 9.
    Törnquist, Agneta
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Social Work. The Swedish Institute for Health Sciences, Lund University.
    Andersson, Magdalena
    Vårdalinstitutet, Lunds universitet.
    Edberg, Anna-Karin
    Kristianstads universitet.
    In search of legitimacy - registered nurses' experience of providing palliative care in a municipal context2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 3, p. 651-658Article in journal (Refereed)
    Abstract [en]

    Background: The palliative care approach was originally developed for hospice care and for persons with cancer diseases, but has gradually expanded to embrace other contexts and people of all ages, with various life-threatening diseases. The palliative care concept thus also applies to older people and the context of municipal care, where Registered Nurses (RNs) hold key care provision positions. The municipal context is not, however, focused primarily on advanced nursing care, and it is important to highlight RNs’ prerequisites for care provision.

    Aim: The study’s aim was to describe RNs’ experience of providing palliative care for older people in a municipal context. Data were collected through focus group discussions with 20 RNs from four different municipalities in southern Sweden and were analysed using conventional content analysis.

    Findings:The results showed that the nurses experienced that it was they who cushioned the effects of unclear responsibilities between different organizations, but had limited legitimacy in the municipal context and in relation to other care providers. The results also showed that nurses lacked proper support and prerequisites for providing high-quality palliative care to older dying patients.

    Conclusion:The results pinpoint the importance of increased acknowledgement of nurses’ knowledge and skills and a critical view on the effects of moving towards an organization composed of different consultants, which can lead to even more unclear responsibility for nursing care provision.

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