Patients' willingness to participate in clinical research is crucial for producing meaningful and... more Patients' willingness to participate in clinical research is crucial for producing meaningful and generalizable results. 1,2 Today, many studies fail to reach representativeness, 3,4 regardless of study design, country or field of research. 5,6 For example, a review found that only a third of the original target population were recruited in randomized, controlled multicenter studies performed in the UK between 1994 and 2002. 7 In addition to the risk of misleading outcomes, 8 scientists are also often forced to cancel research in advance due to an insufficient number of participants. 6 Participant recruitment in psychiatric research is particularly unsatisfying. 9,10 For example, only
Objective Few studies report about the feedback students receive in undergraduate psychiatry trai... more Objective Few studies report about the feedback students receive in undergraduate psychiatry training. The aim of this study was to evaluate an effort to optimize feedback to medical students during rotations in psychiatry. Methods A structured feedback tool was constructed and introduced during psychiatric rotations. At the end of each week during 3 weeks of clinical psychiatry training, 86 medical students anonymously reported whether they had received any feedback, if the new feedback tool had been used and if the received feedback felt valuable. At the end of rotations, students were also asked to leave text comments about their experience of the feedback tool. Course evaluations concerning perceived feedback, before and after introducing a feedback tool, were compared. Results The 86 students reported about feedback at three occasions, leaving a total of 212 reports (82% response rate). In all reports, the students affirmed having received some feedback, either with or without the feedback tool. In the 123 (58%) reports where feedback was received with the feedback tool, 110 (89%) answered that the feedback was experienced as valuable. Among those 89 (42%) reports where feedback had been delivered without the feedback tool, 41 (46%) described the feedback as valuable. Course evaluation of perceived feedback improved. Conclusions Feedback to medical students during psychiatry rotations seems to be optimized by using a structured feedback tool.
OBJECTIVE Borderline personality disorder (BPD) is characterized by instability in emotions, rela... more OBJECTIVE Borderline personality disorder (BPD) is characterized by instability in emotions, relationships, and behaviors, such as self-injury and suicidal behavior. Dialectical Behavioral Therapy (DBT) is an established intervention for BPD, but there are long waiting times for treatment. This study aimed to explore if a brief internet-delivered DBT skills training program with minimal therapist support is acceptable, that it can be administered, useful, and does not do harm for patients with BPD. METHODS Acceptability was measured through data on recruitment and attrition, utilization of the intervention, reported impulses to drop out, and through ratings on self-injury and suicidality. Participants were interviewed about their experiences of the intervention; analyzed with content analysis. RESULTS Twenty patients on the waiting list for treatment at a DBT-clinic were invited and nine female patients (age 19-37 years) volunteered. The participants completed a large part of the intervention, which did not appear harmful since ratings of suicidal and self-harming behavior were similar before and after the intervention. In the interviews, participants stated that they had gained new knowledge and skills to manage situations, e.g. to stop and think before acting. Some even reported decreased levels of self-injury. The time spent on patient contact was short, and some patients reported difficulties to practice on their own and requested more support. CONCLUSIONS The intervention seems to be acceptable. Future studies should investigate in what ways some BPD patients are more susceptible to internet-delivered skills training than others, and if this intervention could be delivered within a stepped-care model.
Additional file 1. The Drinking Motives Questionnaire in the version used in the study. English t... more Additional file 1. The Drinking Motives Questionnaire in the version used in the study. English translation supplied.
The aim of the study was to describe nursing and medical students' experiences of participati... more The aim of the study was to describe nursing and medical students' experiences of participation in an interprofessional education (IPE) activity, "round school," during their clinical rotations in psychiatric care. Data were collected in six focus groups with 32 students from nursing and medical programs, focusing on their experiences of the IPE activity and their reflections on interprofessional collaboration. The students considered the round school to be meaningful and true-to-life. Important conditions for learning were well-informed staff, sufficient time for preparation and feedback, clear routines, instructions, and an open climate. Non-explicit instructions and limited preunderstanding of psychiatric care left the students feeling uncertain. Students' reflections regarding interprofessional competences encompassed both similarities and differences in roles, responsibilities, and collaboration. Evidence of hierarchical and stereotypical images of the nurse-physician relationship was identified. Round school is an example of how IPE can be integrated into the units' regular ward rounds. However, if the clinical everyday work is not based on collaboration between different professions, it can be arduous to implement IPE. Well-planned preparations are necessary, both in the clinic and at the faculty.
Self-report questionnaires on alcohol use are commonly used in both research and in clinical work... more Self-report questionnaires on alcohol use are commonly used in both research and in clinical work with adolescents, but little is known about how adolescent responders perceive and interpret them. This study explores how adolescents think while responding to two alcohol-related questionnaires. It also investigates whether the instruments can initiate self-reflective processes on alcohol use. Data were collected among adolescents visiting a center for young people with substance use problems in Sweden. The participants found the questionnaires easy to complete and widely relevant, and the questionnaires commonly initiated a process of self-reflection. Results support the use in clinical settings.
BackgroundRecovery rates after psychological treatments for anorexia nervosa are low to moderate,... more BackgroundRecovery rates after psychological treatments for anorexia nervosa are low to moderate, and in adults, no treatment outperforms any other. The aim of this study was to evaluate patient experiences of Radically open dialectical behavior therapy (RO DBT), a treatment developed for disorders related to maladaptive overcontrol.MethodsEleven female patients with anorexia nervosa were interviewed after either treatment completion (eight patients) or drop-out (three patients) from RO DBT. Interviews were transcribed and analyzed with inductive thematic analysis.ResultsThe analysis yielded five main themes: 1) a comprehensive treatment, 2) the benefits of sharing and connecting with others, 3) growing trust, 4) moving toward valued goals – but some remain, and 5) doing well in treatment.ConclusionPatients appreciated what they described as a comprehensive treatment and holistic view of their problems, which helped them reduce both maladaptive overcontrol and eating disorder sympto...
Little is known about how adolescents with attention deficit/hyperactivity disorder (ADHD) experi... more Little is known about how adolescents with attention deficit/hyperactivity disorder (ADHD) experience participating in group therapy, an important factor to consider when developing treatment methods for this age group. This study aimed to explore how adolescents with ADHD experience participating in a structured skills training group program based on dialectical behavioral therapy. Semi‐structured interviews were conducted with 20 adolescents (15–18 years of age) with ADHD after participating in a structured skills training group. The interviews were transcribed verbatim and qualitative content analysis were used to analyze the text. The participants emphasized the value of meeting other adolescents with ADHD and the opportunity to exchange experiences, strategies and tips. Participating in the group treatment made the adolescents realize that they were not alone, and feelings of togetherness and an increased acceptance of themselves were described. The participants associated the ...
Although opioid maintenance treatment lowers mortality and has proven efficacy in reducing opioid... more Although opioid maintenance treatment lowers mortality and has proven efficacy in reducing opioid use, it is not an option for every person with an opioid addiction. Studies of the experiences of those who have overcome their addiction without pharmaceuticals are rare, but vital to understanding the quitting process and how it can be facilitated. This study investigated what persons with a previous heroin addiction perceived as helpful when overcoming their addiction without the use of pharmaceuticals, and what they consider important for health services to consider. Eleven adults with former heroin addiction participated. Most described the leaving process as prolonged and including many attempts. Experiences such as being worn out and numb, life-threatening overdoses, personal losses or a growing feeling of missing important stages in life fueled the decision process. Envisioning a future without drugs was described as an important component. To maintain the decision to refrain from heroin use the possibility to gain a new social context was crucial. Results imply that health care professionals should be proactive by seizing the moment of opportunity for change (e.g., after an overdose), and should be empathetic and never give up on a person. Those concerned with care, welfare and other support or control systems in society must cooperate to offer more personalized support.
Objective Few studies report about the feedback students receive in undergraduate psychiatry trai... more Objective Few studies report about the feedback students receive in undergraduate psychiatry training. The aim of this study was to evaluate an effort to optimize feedback to medical students during rotations in psychiatry. Methods A structured feedback tool was constructed and introduced during psychiatric rotations. At the end of each week during 3 weeks of clinical psychiatry training, 86 medical students anonymously reported whether they had received any feedback, if the new feedback tool had been used and if the received feedback felt valuable. At the end of rotations, students were also asked to leave text comments about their experience of the feedback tool. Course evaluations concerning perceived feedback, before and after introducing a feedback tool, were compared. Results The 86 students reported about feedback at three occasions, leaving a total of 212 reports (82% response rate). In all reports, the students affirmed having received some feedback, either with or without the feedback tool. In the 123 (58%) reports where feedback was received with the feedback tool, 110 (89%) answered that the feedback was experienced as valuable. Among those 89 (42%) reports where feedback had been delivered without the feedback tool, 41 (46%) described the feedback as valuable. Course evaluation of perceived feedback improved. Conclusions Feedback to medical students during psychiatry rotations seems to be optimized by using a structured feedback tool.
Craniosynostosis is usually diagnosed in early infancy. Treatment almost always involves surgery ... more Craniosynostosis is usually diagnosed in early infancy. Treatment almost always involves surgery and care is optimally organized around an interdisciplinary team of specialists at a craniofacial center. This study aimed to investigate Swedish parents' experiences of having a child with craniosynostosis and their perceptions of the initial care process. Semistructured telephone interviews were conducted with 20 parents (10 fathers and 10 mothers) of children with nonsyndromic craniosynostosis who were undergoing surgery at the Uppsala Craniofacial Center. A thematic data analysis revealed 6 themes presented in a timeline following the parents' journey from detection of their child's abnormal skull shape to waiting for surgery: Detection of the abnormal skull shape, thoughts, and feelings before the appointment with the craniofacial team, an appointment with the craniofacial team, searching the Internet and social media, waiting for surgery, and suggestions for improvement. Although meeting with the craniofacial team was considered informative, parents expressed concerns about surgery and their infant's long-term prognosis were evident. Most parents had no previous knowledge about craniosynostosis and craniofacial syndromes and wished for more information already at the time of its detection. The Internet was used both at the time of suspicion that something was wrong with the child and later to learn about risks and consequences, alternative treatments and prognosis.
Substance Abuse Treatment, Prevention, and Policy, 2019
Background Alcohol consumption is generally high among undergraduate students and may lead to adv... more Background Alcohol consumption is generally high among undergraduate students and may lead to adverse consequences. Drinking motives play a vital role in the development of alcohol-related problems. The Drinking Motives Questionnaire-Revised (DMQ-R) and the short form of DMQ-R, DMQ-R SF, are widely used tools to identify drinking motives. Still, there is a need for further exploration of the instruments in different cultures and settings. The aims of this study were 1) to explore the four-factor structure of the DMQ-R and DMQ-R SF in Swedish undergraduate students 2) to investigate if extracting the SF responses from the DMQ-R is equivalent to the factor structure of the DMQ-R SF 3) to study the association between drinking motives and hazardous drinking. Methods Data were collected among 536 Swedish undergraduate students and were analyzed by confirmatory factor analyses, Mann-Whitney, chi-square tests and logistic regressions. Results We could confirm the four-dimensional structur...
Introduction: This qualitative study aims to explore former burn patients' perception of burn-spe... more Introduction: This qualitative study aims to explore former burn patients' perception of burn-specific health and investigate how these experiences correspond to the subscales in the Burn Specific Health Scale-Brief (BSHS-B). Method: Respondents were former burn patients, admitted to the Uppsala Burn Centre between 2000 and 2007. A total of 20 respondents with a Total Body Surface Area (TBSA) of 20% or larger, were approached at 10À17years after burn and interviewed using a semi-structured guide. Data was analyzed using thematic analysis. Results: Despite extensive burn injuries, respondents said they led a close-to-normal life. Their descriptions validated the significance of the existing themes of BSHS-B. Additional themes of importance for health after burn were skin related problems, morphine de-escalation, the importance of work, stress and avoidance, mentality and the healthcare system. Conclusion: The BSHS-B alone may not be sufficient in providing a comprehensive picture of former burn patients' self-perceived health in the long-term perspective. Investigating supplementary areas reflecting former patients' sociocultural and attitudinal environment, as well as personal factors, may be of great importance.
BackgroundMeaningful and generalizable research depends on patients' willingness to participa... more BackgroundMeaningful and generalizable research depends on patients' willingness to participate. Studies often fail to reach satisfactory representativeness.ObjectiveThis paper aims to investigate reasons for not participating in research among young adult patients with psychiatric illness.MethodA quantitative cross‐sectional study was performed based on questionnaires reported on by 51 psychiatric patients (14 males, 35 females and two unspecified) who had previously declined participation in an ongoing research project. Thereafter, a qualitative interview with subsequent content analysis was conducted with ten additional patients (five males, five females).ResultsThe questionnaires indicate being ‘too tired/too sick to participate’ as the most common barrier. Lack of time and fear of needles were other common barriers. Lack of trust or belief in the value of research was less inhibitive. In the interviews, disabling psychiatric symptoms were confirmed as the main reason for no...
Nursing in psychiatric care has been accused of a lack of autonomy and becoming instrumental by a... more Nursing in psychiatric care has been accused of a lack of autonomy and becoming instrumental by acquiescing to the medical model, mostly focusing on delivering treatments prescribed by physicians (Bladon, 2017; Lakeman & Molloy, 2017). Specifically, nursing has been described as having a marginalized status (Holmberg, Caro, & Sobis, 2018), unclear role definition (Delaney & Johnson, 2014) and being invisible (Harrison, Hauck, & Ashby, 2017), all of which has led to difficulties in implementation of theories and models (Barker, 2001; Bladon, 2017). Furthermore, psychiatric inpatient care is often confusing from the patients' perspective, creating difficulties to
Despite intensive analgesic treatment, most burn patients suffer from severe pain during the acut... more Despite intensive analgesic treatment, most burn patients suffer from severe pain during the acute phase [1]. This is not only a result of the burn itself but also of the procedures applied to treat the burns (e.g., dressing changes, surgery, wound closure, scar maturation, movement and stretching exercises) [2]. It is known that persistent pain of a peripheral origin may induce pathological changes on a spinal and b u r n s 4 2 (
Background: In the education of professionals in psychiatry, one challenge is to provide clinical... more Background: In the education of professionals in psychiatry, one challenge is to provide clinical placements with opportunities for students to interact and have direct contact with patients. The aim of this study was to explore Swedish psychiatric patients' perspectives on student participation in their care. Method: In a cross-sectional survey design, 655 adult psychiatric patients at a university hospital completed questionnaires. These questionnaires included statements about student involvement, student gender, attitudes towards student participation as well as two open-ended questions. Data were analyzed quantitatively and qualitatively. Results: The majority of the patients were comfortable with student participation. There were no differences between patients in wards compared to outpatients but patients who previously had students involved in their care reported higher comfort levels and a more positive attitude. Female patients were less comfortable with male students and very young students. Patients stressed the importance of being informed about the opportunity to refuse student participation. More detailed information given before the consultation as well as the importance of the student showing a professional attitude was conditions that could enable more patients to endorse student participation. Conclusion: The psychiatric patients' overall positive attitudes are in line with previous findings from other specialties and countries. The results support both altruistic motives and experience of personal gains by student involvement. More detailed information given beforehand would enable more patients to consider student participation.
The number of children who work on the streets is increasing worldwide, especially in developing ... more The number of children who work on the streets is increasing worldwide, especially in developing countries, due to population growth and rapid urbanisation. 1 Many studies have identified poverty as the most common reason for children to be on the streets, 2 followed by family reasons. These include large families, parents who are authoritative, have health problems, abuse substances or are absent, 3,4 domestic violence, child neglect and abuse, 4,5 school problems 6,7 and peer pressure. 5 Street-working children often lack proper housing, shelter and access to food 8 and are frequently exposed to road accidents, injuries and burns. 9 They are often deprived of their basic right to education, have little or no access to health care and lack love, affection and care and the protection and supervision of a responsible adult. 10 In addition, they face a greater risk of suppression, harassment, abuse, neglect, exploitation, trafficking and sexual abuse. 11 Street children often report early-onset substance abuse 12,13 and mental health problems, particularly high levels of
Patients' willingness to participate in clinical research is crucial for producing meaningful and... more Patients' willingness to participate in clinical research is crucial for producing meaningful and generalizable results. 1,2 Today, many studies fail to reach representativeness, 3,4 regardless of study design, country or field of research. 5,6 For example, a review found that only a third of the original target population were recruited in randomized, controlled multicenter studies performed in the UK between 1994 and 2002. 7 In addition to the risk of misleading outcomes, 8 scientists are also often forced to cancel research in advance due to an insufficient number of participants. 6 Participant recruitment in psychiatric research is particularly unsatisfying. 9,10 For example, only
Objective Few studies report about the feedback students receive in undergraduate psychiatry trai... more Objective Few studies report about the feedback students receive in undergraduate psychiatry training. The aim of this study was to evaluate an effort to optimize feedback to medical students during rotations in psychiatry. Methods A structured feedback tool was constructed and introduced during psychiatric rotations. At the end of each week during 3 weeks of clinical psychiatry training, 86 medical students anonymously reported whether they had received any feedback, if the new feedback tool had been used and if the received feedback felt valuable. At the end of rotations, students were also asked to leave text comments about their experience of the feedback tool. Course evaluations concerning perceived feedback, before and after introducing a feedback tool, were compared. Results The 86 students reported about feedback at three occasions, leaving a total of 212 reports (82% response rate). In all reports, the students affirmed having received some feedback, either with or without the feedback tool. In the 123 (58%) reports where feedback was received with the feedback tool, 110 (89%) answered that the feedback was experienced as valuable. Among those 89 (42%) reports where feedback had been delivered without the feedback tool, 41 (46%) described the feedback as valuable. Course evaluation of perceived feedback improved. Conclusions Feedback to medical students during psychiatry rotations seems to be optimized by using a structured feedback tool.
OBJECTIVE Borderline personality disorder (BPD) is characterized by instability in emotions, rela... more OBJECTIVE Borderline personality disorder (BPD) is characterized by instability in emotions, relationships, and behaviors, such as self-injury and suicidal behavior. Dialectical Behavioral Therapy (DBT) is an established intervention for BPD, but there are long waiting times for treatment. This study aimed to explore if a brief internet-delivered DBT skills training program with minimal therapist support is acceptable, that it can be administered, useful, and does not do harm for patients with BPD. METHODS Acceptability was measured through data on recruitment and attrition, utilization of the intervention, reported impulses to drop out, and through ratings on self-injury and suicidality. Participants were interviewed about their experiences of the intervention; analyzed with content analysis. RESULTS Twenty patients on the waiting list for treatment at a DBT-clinic were invited and nine female patients (age 19-37 years) volunteered. The participants completed a large part of the intervention, which did not appear harmful since ratings of suicidal and self-harming behavior were similar before and after the intervention. In the interviews, participants stated that they had gained new knowledge and skills to manage situations, e.g. to stop and think before acting. Some even reported decreased levels of self-injury. The time spent on patient contact was short, and some patients reported difficulties to practice on their own and requested more support. CONCLUSIONS The intervention seems to be acceptable. Future studies should investigate in what ways some BPD patients are more susceptible to internet-delivered skills training than others, and if this intervention could be delivered within a stepped-care model.
Additional file 1. The Drinking Motives Questionnaire in the version used in the study. English t... more Additional file 1. The Drinking Motives Questionnaire in the version used in the study. English translation supplied.
The aim of the study was to describe nursing and medical students' experiences of participati... more The aim of the study was to describe nursing and medical students' experiences of participation in an interprofessional education (IPE) activity, "round school," during their clinical rotations in psychiatric care. Data were collected in six focus groups with 32 students from nursing and medical programs, focusing on their experiences of the IPE activity and their reflections on interprofessional collaboration. The students considered the round school to be meaningful and true-to-life. Important conditions for learning were well-informed staff, sufficient time for preparation and feedback, clear routines, instructions, and an open climate. Non-explicit instructions and limited preunderstanding of psychiatric care left the students feeling uncertain. Students' reflections regarding interprofessional competences encompassed both similarities and differences in roles, responsibilities, and collaboration. Evidence of hierarchical and stereotypical images of the nurse-physician relationship was identified. Round school is an example of how IPE can be integrated into the units' regular ward rounds. However, if the clinical everyday work is not based on collaboration between different professions, it can be arduous to implement IPE. Well-planned preparations are necessary, both in the clinic and at the faculty.
Self-report questionnaires on alcohol use are commonly used in both research and in clinical work... more Self-report questionnaires on alcohol use are commonly used in both research and in clinical work with adolescents, but little is known about how adolescent responders perceive and interpret them. This study explores how adolescents think while responding to two alcohol-related questionnaires. It also investigates whether the instruments can initiate self-reflective processes on alcohol use. Data were collected among adolescents visiting a center for young people with substance use problems in Sweden. The participants found the questionnaires easy to complete and widely relevant, and the questionnaires commonly initiated a process of self-reflection. Results support the use in clinical settings.
BackgroundRecovery rates after psychological treatments for anorexia nervosa are low to moderate,... more BackgroundRecovery rates after psychological treatments for anorexia nervosa are low to moderate, and in adults, no treatment outperforms any other. The aim of this study was to evaluate patient experiences of Radically open dialectical behavior therapy (RO DBT), a treatment developed for disorders related to maladaptive overcontrol.MethodsEleven female patients with anorexia nervosa were interviewed after either treatment completion (eight patients) or drop-out (three patients) from RO DBT. Interviews were transcribed and analyzed with inductive thematic analysis.ResultsThe analysis yielded five main themes: 1) a comprehensive treatment, 2) the benefits of sharing and connecting with others, 3) growing trust, 4) moving toward valued goals – but some remain, and 5) doing well in treatment.ConclusionPatients appreciated what they described as a comprehensive treatment and holistic view of their problems, which helped them reduce both maladaptive overcontrol and eating disorder sympto...
Little is known about how adolescents with attention deficit/hyperactivity disorder (ADHD) experi... more Little is known about how adolescents with attention deficit/hyperactivity disorder (ADHD) experience participating in group therapy, an important factor to consider when developing treatment methods for this age group. This study aimed to explore how adolescents with ADHD experience participating in a structured skills training group program based on dialectical behavioral therapy. Semi‐structured interviews were conducted with 20 adolescents (15–18 years of age) with ADHD after participating in a structured skills training group. The interviews were transcribed verbatim and qualitative content analysis were used to analyze the text. The participants emphasized the value of meeting other adolescents with ADHD and the opportunity to exchange experiences, strategies and tips. Participating in the group treatment made the adolescents realize that they were not alone, and feelings of togetherness and an increased acceptance of themselves were described. The participants associated the ...
Although opioid maintenance treatment lowers mortality and has proven efficacy in reducing opioid... more Although opioid maintenance treatment lowers mortality and has proven efficacy in reducing opioid use, it is not an option for every person with an opioid addiction. Studies of the experiences of those who have overcome their addiction without pharmaceuticals are rare, but vital to understanding the quitting process and how it can be facilitated. This study investigated what persons with a previous heroin addiction perceived as helpful when overcoming their addiction without the use of pharmaceuticals, and what they consider important for health services to consider. Eleven adults with former heroin addiction participated. Most described the leaving process as prolonged and including many attempts. Experiences such as being worn out and numb, life-threatening overdoses, personal losses or a growing feeling of missing important stages in life fueled the decision process. Envisioning a future without drugs was described as an important component. To maintain the decision to refrain from heroin use the possibility to gain a new social context was crucial. Results imply that health care professionals should be proactive by seizing the moment of opportunity for change (e.g., after an overdose), and should be empathetic and never give up on a person. Those concerned with care, welfare and other support or control systems in society must cooperate to offer more personalized support.
Objective Few studies report about the feedback students receive in undergraduate psychiatry trai... more Objective Few studies report about the feedback students receive in undergraduate psychiatry training. The aim of this study was to evaluate an effort to optimize feedback to medical students during rotations in psychiatry. Methods A structured feedback tool was constructed and introduced during psychiatric rotations. At the end of each week during 3 weeks of clinical psychiatry training, 86 medical students anonymously reported whether they had received any feedback, if the new feedback tool had been used and if the received feedback felt valuable. At the end of rotations, students were also asked to leave text comments about their experience of the feedback tool. Course evaluations concerning perceived feedback, before and after introducing a feedback tool, were compared. Results The 86 students reported about feedback at three occasions, leaving a total of 212 reports (82% response rate). In all reports, the students affirmed having received some feedback, either with or without the feedback tool. In the 123 (58%) reports where feedback was received with the feedback tool, 110 (89%) answered that the feedback was experienced as valuable. Among those 89 (42%) reports where feedback had been delivered without the feedback tool, 41 (46%) described the feedback as valuable. Course evaluation of perceived feedback improved. Conclusions Feedback to medical students during psychiatry rotations seems to be optimized by using a structured feedback tool.
Craniosynostosis is usually diagnosed in early infancy. Treatment almost always involves surgery ... more Craniosynostosis is usually diagnosed in early infancy. Treatment almost always involves surgery and care is optimally organized around an interdisciplinary team of specialists at a craniofacial center. This study aimed to investigate Swedish parents' experiences of having a child with craniosynostosis and their perceptions of the initial care process. Semistructured telephone interviews were conducted with 20 parents (10 fathers and 10 mothers) of children with nonsyndromic craniosynostosis who were undergoing surgery at the Uppsala Craniofacial Center. A thematic data analysis revealed 6 themes presented in a timeline following the parents' journey from detection of their child's abnormal skull shape to waiting for surgery: Detection of the abnormal skull shape, thoughts, and feelings before the appointment with the craniofacial team, an appointment with the craniofacial team, searching the Internet and social media, waiting for surgery, and suggestions for improvement. Although meeting with the craniofacial team was considered informative, parents expressed concerns about surgery and their infant's long-term prognosis were evident. Most parents had no previous knowledge about craniosynostosis and craniofacial syndromes and wished for more information already at the time of its detection. The Internet was used both at the time of suspicion that something was wrong with the child and later to learn about risks and consequences, alternative treatments and prognosis.
Substance Abuse Treatment, Prevention, and Policy, 2019
Background Alcohol consumption is generally high among undergraduate students and may lead to adv... more Background Alcohol consumption is generally high among undergraduate students and may lead to adverse consequences. Drinking motives play a vital role in the development of alcohol-related problems. The Drinking Motives Questionnaire-Revised (DMQ-R) and the short form of DMQ-R, DMQ-R SF, are widely used tools to identify drinking motives. Still, there is a need for further exploration of the instruments in different cultures and settings. The aims of this study were 1) to explore the four-factor structure of the DMQ-R and DMQ-R SF in Swedish undergraduate students 2) to investigate if extracting the SF responses from the DMQ-R is equivalent to the factor structure of the DMQ-R SF 3) to study the association between drinking motives and hazardous drinking. Methods Data were collected among 536 Swedish undergraduate students and were analyzed by confirmatory factor analyses, Mann-Whitney, chi-square tests and logistic regressions. Results We could confirm the four-dimensional structur...
Introduction: This qualitative study aims to explore former burn patients' perception of burn-spe... more Introduction: This qualitative study aims to explore former burn patients' perception of burn-specific health and investigate how these experiences correspond to the subscales in the Burn Specific Health Scale-Brief (BSHS-B). Method: Respondents were former burn patients, admitted to the Uppsala Burn Centre between 2000 and 2007. A total of 20 respondents with a Total Body Surface Area (TBSA) of 20% or larger, were approached at 10À17years after burn and interviewed using a semi-structured guide. Data was analyzed using thematic analysis. Results: Despite extensive burn injuries, respondents said they led a close-to-normal life. Their descriptions validated the significance of the existing themes of BSHS-B. Additional themes of importance for health after burn were skin related problems, morphine de-escalation, the importance of work, stress and avoidance, mentality and the healthcare system. Conclusion: The BSHS-B alone may not be sufficient in providing a comprehensive picture of former burn patients' self-perceived health in the long-term perspective. Investigating supplementary areas reflecting former patients' sociocultural and attitudinal environment, as well as personal factors, may be of great importance.
BackgroundMeaningful and generalizable research depends on patients' willingness to participa... more BackgroundMeaningful and generalizable research depends on patients' willingness to participate. Studies often fail to reach satisfactory representativeness.ObjectiveThis paper aims to investigate reasons for not participating in research among young adult patients with psychiatric illness.MethodA quantitative cross‐sectional study was performed based on questionnaires reported on by 51 psychiatric patients (14 males, 35 females and two unspecified) who had previously declined participation in an ongoing research project. Thereafter, a qualitative interview with subsequent content analysis was conducted with ten additional patients (five males, five females).ResultsThe questionnaires indicate being ‘too tired/too sick to participate’ as the most common barrier. Lack of time and fear of needles were other common barriers. Lack of trust or belief in the value of research was less inhibitive. In the interviews, disabling psychiatric symptoms were confirmed as the main reason for no...
Nursing in psychiatric care has been accused of a lack of autonomy and becoming instrumental by a... more Nursing in psychiatric care has been accused of a lack of autonomy and becoming instrumental by acquiescing to the medical model, mostly focusing on delivering treatments prescribed by physicians (Bladon, 2017; Lakeman & Molloy, 2017). Specifically, nursing has been described as having a marginalized status (Holmberg, Caro, & Sobis, 2018), unclear role definition (Delaney & Johnson, 2014) and being invisible (Harrison, Hauck, & Ashby, 2017), all of which has led to difficulties in implementation of theories and models (Barker, 2001; Bladon, 2017). Furthermore, psychiatric inpatient care is often confusing from the patients' perspective, creating difficulties to
Despite intensive analgesic treatment, most burn patients suffer from severe pain during the acut... more Despite intensive analgesic treatment, most burn patients suffer from severe pain during the acute phase [1]. This is not only a result of the burn itself but also of the procedures applied to treat the burns (e.g., dressing changes, surgery, wound closure, scar maturation, movement and stretching exercises) [2]. It is known that persistent pain of a peripheral origin may induce pathological changes on a spinal and b u r n s 4 2 (
Background: In the education of professionals in psychiatry, one challenge is to provide clinical... more Background: In the education of professionals in psychiatry, one challenge is to provide clinical placements with opportunities for students to interact and have direct contact with patients. The aim of this study was to explore Swedish psychiatric patients' perspectives on student participation in their care. Method: In a cross-sectional survey design, 655 adult psychiatric patients at a university hospital completed questionnaires. These questionnaires included statements about student involvement, student gender, attitudes towards student participation as well as two open-ended questions. Data were analyzed quantitatively and qualitatively. Results: The majority of the patients were comfortable with student participation. There were no differences between patients in wards compared to outpatients but patients who previously had students involved in their care reported higher comfort levels and a more positive attitude. Female patients were less comfortable with male students and very young students. Patients stressed the importance of being informed about the opportunity to refuse student participation. More detailed information given before the consultation as well as the importance of the student showing a professional attitude was conditions that could enable more patients to endorse student participation. Conclusion: The psychiatric patients' overall positive attitudes are in line with previous findings from other specialties and countries. The results support both altruistic motives and experience of personal gains by student involvement. More detailed information given beforehand would enable more patients to consider student participation.
The number of children who work on the streets is increasing worldwide, especially in developing ... more The number of children who work on the streets is increasing worldwide, especially in developing countries, due to population growth and rapid urbanisation. 1 Many studies have identified poverty as the most common reason for children to be on the streets, 2 followed by family reasons. These include large families, parents who are authoritative, have health problems, abuse substances or are absent, 3,4 domestic violence, child neglect and abuse, 4,5 school problems 6,7 and peer pressure. 5 Street-working children often lack proper housing, shelter and access to food 8 and are frequently exposed to road accidents, injuries and burns. 9 They are often deprived of their basic right to education, have little or no access to health care and lack love, affection and care and the protection and supervision of a responsible adult. 10 In addition, they face a greater risk of suppression, harassment, abuse, neglect, exploitation, trafficking and sexual abuse. 11 Street children often report early-onset substance abuse 12,13 and mental health problems, particularly high levels of
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