People In Sweden Research Articles

COVID-19 and mental health among older people in Sweden.

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Perceptions of Professional Responsibility When Caring for Older People in Home Care in Sweden

ABSTRACT Older people in Sweden are increasingly being cared for in the own home, where professional caregivers play an important role. This study aimed to describe perceptions of caring responsibility in the context of older people’s homes from the perspective of professional caregivers from caring professions. Fourteen interviews were conducted with professional caregivers from different professions. The result show how professional caregivers perceive responsibility as limitless, constrained by time, moral, overseeing, meaningful and lonesome. Responsibility seems to affect caregivers to a large extent when the burden is high. Professional caregivers’ perceptions of responsibility, and the potential consequences of a perceived strained work situation therefore need to be addressed. The findings also indicate a need for professional support and guidance when it is difficult to distinguish between professional and personal responsibility.

Complexities of sexual consent: young people’s reasoning in a Swedish context

ABSTRACT Although previous research and public debate argue that partnered sexual activity is construed in terms of being consensual or not, we know little about young people’s own reasoning on sexual consent. This study aimed to investigate how sexual consent and sexual negotiations are interpreted by young people in Sweden. Forty-four female and male participants, ranging from 18–21 years old, took part in 12 focus groups, organised according to a set of vignettes. All focus groups were analysed using inductive thematic analysis. The findings illustrate the complexity of the interpretation of sexual consent. There was a clear perception among the participants that sex between two individuals is a mutual process, and that sex should be consensual, expressed either through words, body language, or both. They all stated clearly that a ‘No’ has to be respected, independently of context. However, at the same time participants expressed contradictory norms and expectations in relation to the described situations, that showed an ambivalence concerning sexual scripts and consequences of challenging these in specific situations. Reasoning concerning discrepancy between ideals and actual possibilities to act in sexual encounters indicates differences in relation to gender, age and educational background and pathways.

Prerequisites for a healthy and independent life among older people: a Delphi study

AbstractThe number of older people (aged 65+) will more than double by 2050 in Sweden. The ageing population is an increasing concern due to rising health-care costs and a shortage of health professionals. Older people generally prefer ageing in place, as long as they feel confident and comfortable. However, preventive and supportive measures are needed to maintain older people's independence and active participation in society. The aim of this study is to explore the prerequisites for a healthy and independent life among older people in Sweden. A Delphi study was conducted in three rounds. In round 1, seven focus group interviews were performed with older persons aged 65–79, older persons aged ⩾80, next of kin of older persons, health professionals in primary and home health care, assistant nurses in home care, care managers and local politicians. The data were analysed using thematic analysis, resulting in 35 statements of the prerequisites needed for a healthy and independent life. These statements were sent to the participants from round 1, who were asked to evaluate the degree to which they agreed with each statement in round 2, and again in round 3. There was an agreement of at least 80 per cent for 31 of the 35 statements. When asked to identify the three prerequisites of most importance for a healthy and independent life, most participants stated: to have a social life, to have freedom of choice and power over one's own situation, and to have the possibility to choose independently one's type of housing. There was an overall high group agreement on the prerequisites needed for a healthy and independent life among older people. The main areas of importance were to have a social life, several dimensions of feeling safe and to retain one's personal control.

Needle Fasciotomy or Collagenase Injection in the Treatment of Dupuytren's Contracture: A Retrospective Study.

Background:Dupuytren’s contracture is common among older people in Sweden. Previous studies comparing the treatment with an injection of collagenase with percutaneous needle fasciotomy found no differences.Methods:We retrospectively compared the degree of improvement in the deficit in extension of the joints in 2 groups of patients who had been treated with collagenase (71 fingers) or needle fasciotomy (109 fingers) before and 1 year after treatment. We compared the improvement of the extension deficit among the metacarpophalangeal (MCP) and proximal interphalangeal joints before and after the intervention; additionally, the level of improvement was classified into 3 levels (mild = 0° to 29°; moderate = 30° to 60°; considerable = 61° and more).Results:The degree of improvement of extension in the MCP joints was 11° greater in the collagenase group (P = 0.001). The number of patients who had an improvement of >60° (considerable) in extension was greater in the collagenase group (P = 0.02).Conclusion:Collagenase was more effective than needle fasciotomy in treating extension deficits of the MCP joints in Dupuytren’s contracture in this retrospective analysis. Further prospective studies are required to confirm the finding.

Interrelated Factors for Return to Work of Sick-Listed Employees in Sweden

Abstract Purpose: Long-term sickness absence is a significant human and economic cost in many countries, including Sweden making research on factors which impact on return to work (RTW) relevant. This study has two aims: (1) provide an overview of factors that impact RTW expectations in a national sample of Swedish workers on long-term sickness absence; and (2) gain an understanding of the interrelationships among these factors using a socioecological framework and decision tree analysis. Method: A survey, designed to capture information about demographic variables, health and work ability, workplace contact, supervisor support and expectations of return to work, was mailed to 1,112 randomly selected sick-listed people in Sweden and completed by 534, representing a response rate of 48%. Results: The most important factors affecting RTW expectations were work ability and burnout. Employees reporting high levels of work ability were more likely to expect to RTW compared to those reporting low levels, and this was dependent on their relative burnout score. Those with a high burnout score were less likely to expect to RTW, while for those with a low burnout score RTW expectations were dependent on age, country of birth, and supervisor support. For young employees reporting low work ability and low burnout score, RTW expectations were lower. Conclusions: Our results suggest a more nuanced approach to delivery of RTW services is required, whereby practitioners need to understand the socioecology of the range of factors that impact RTW expectations. The use of decision tree analysis facilitates this understanding by describing the interrelationships between these factors.

Illuminating the gendered nature of health-promoting activities among nursing staff in forensic psychiatric care.

When people in Sweden are sentenced and handed over to forensic psychiatric care (FPC), the authorities have overall responsibility for their health recovery. How nursing staff construct gender through their relations in this context affects their understanding of health promotion activities. The aim of this study was to illuminate, using a gender perspective, the understanding of nursing staff with respect to health promotion activities for patients. Four focus group interviews were conducted with nursing staff in two FPC clinics in Sweden. The study has a qualitative inductive design with an ethnographic approach. This study sheds new light on FPC in which its dual goals of protecting society and providing care are viewed from a gender perspective. When relationships within the nursing staff group and the nurse-patient relationship are justified by the goal of protecting society, gender becomes invisible. This might cause patients' individual conditions and needs for certain types of activities to go unnoticed. One of the implications of ignoring gender relations in nursing staff health promotion activities is that it risks contributing to gender stereotypes which impact on the nurse-patient relationship and the quality of care.

Societal costs of informal care of community-dwelling frail elderly people.

Aims: The aims of this study are to describe informal care activities and to estimate the societal cost of informal care of community-dwelling frail elderly people in Sweden. Methods: This study was performed within the frame of the TREEE project that included 408 frail elderly patients. At index hospitalisation (baseline), primary informal caregivers of the patients were provided with a questionnaire on informal care during a period of three months. Questions concerning other (secondary) informal caregivers were also included. A rough estimate of the total cost of informal care of frail elderly people in Sweden was obtained by combining data from this study with published data and official statistics. Results: In total, 176 informal caregivers responded, and 89% had provided informal care. The informal caregivers (primary and secondary) provided care for an average of 245 hours over three months. Taking care of the home was the dominating activity. In total, the mean cost of informal care was estimated to approximately 18,000 SEK (€1878) over three months, corresponding to an annual cost of approximately 72,000 SEK (€7477) per frail elderly person. The total annual societal costs of informal care of community dwelling frail elderly people aged 75 years and older in Sweden was estimated to be approximately 11,000 million SEK (€1150 million). Conclusions: The care of frail elderly people provided by informal caregivers is extensive and represents a great economic value. Although our calculations are associated with uncertainty, the size indicates that supporting informal caregivers should be a priority for society.

Bandy v. ice hockey in Sweden

In 1920, the year ice hockey was introduced to Sweden in connection with the Olympic Games in Antwerp, the traditional British bandy was already a well established team sport on ice in the country. In the early 1900s it had become popular among the upper classes, both men and women, since its deep connection with nature applied to the time’s sense of nostalgia. The Swedish male bandy cup final, which was first played in 1907, is still the country’s oldest large-scale annual sports event. In the press, comparisons were constantly made between the two sports and bandy and ice hockey were seen as contrasts. This resulted in bandy being regarded as truly Swedish and part of the native culture. Concurrently, the sport spread to the working people in Sweden’s rural manufacturing towns while the capital Stockholm established itself as the centre for ice hockey. Elaborating on Allen Guttmann’s theories on modernization, ice hockey’s higher degree of modernity is presented. Adjusting to the modern world was a struggle for bandy and therefore followers of ice hockey predicted its early demise. Still it survived, however surrounded by an even stronger atmosphere of nature-centred nostalgia. The increasingly Americanized sport of ice hockey, on the other hand, became the main player in the growing commercialization of Swedish sport.

Redress for Involuntarily Sterilised Trans People in Sweden against Evolving Human Rights Standards: A Critical Appraisal

Abstract Involuntary sterilisation is a long-standing practice that has targeted vulnerable and marginalised groups in different historical and geographical contexts. These include transgender and transsexual people who have often had to undergo sterilisation as a requirement for legal gender recognition. During the last decades, the international community has started to recognise involuntary sterilisation as a violation of human rights, with remedial implications flowing from state responsibility. To date, however, no binding remedial human rights standards have been established with reference to trans people specifically. Importantly, in March 2018, the Swedish Parliament approved legislation to compensate sterilised trans people on an ex gratia basis. This article evaluates the new Swedish legislation against developing human rights remedial standards. While pointing out enduring shortcomings, it welcomes the remedial initiative in the Swedish Compensation Act, highlighting the need for equal and coherent international remedial standards concerning involuntarily sterilised persons regardless of their gender identity.

Understanding the complexity of socioeconomic disparities in type 2 diabetes risk: a study of 4.3 million people in Sweden

ObjectiveInvestigating demographic and socioeconomic factors as intersecting rather than as separate dimensions may improve our understanding of the heterogeneous distribution of type 2 diabetes in the population. However, this complexity...

'Contradictions in having care providers with a South Sami background who speak South Sami': older South Sami People in Sweden's expectations of home nursing care.

The Sami are an indigenous population with multiple languages and dialects living in northern areas of Sweden, Norway, Finland, and the Kola Peninsula. The South Sami population lives in central regions of Sweden and Norway, and consist of about 2000 people. In this study, 56 older South Sami people from Sweden participated. Semi-structured interviews were conducted over the telephone and analysed through qualitative content analysis. The main findings show that older South Sami people's expectations of having care providers with a South Sami background speaking South Sami in home nursing care contain contradictions in and between participants. Participants had different preferences regarding having care providers with a South Sami background speaking South Sami in the future. When providing care to older South Sami people, individual adjustments are of importance, and our study showed that participants had different expectations despite having similar backgrounds.

‘The same care providers over time who make individual adjustments and have competence’ Older South Sami People in Sweden's expectations of home nursing care

This study is part of a larger research project designed to examine the view of home nursing care from the perspective of older South Sami people in Sweden. In the present study, we present findings from the point of view of their expectations of home nursing care. The Sami are an indigenous population living in northern Sweden, Norway, Finland and the Kola Peninsula, and consist of different Sami people, of which the South Sami population is one. This population consists of approximately 2000 persons living in the central regions of Sweden and Norway. Fifty-six older South Sami people participated in the study. Semi-structured interviews were conducted over the telephone and were analysed using latent content analysis. The main findings show how older South Sami people's expectation for home nursing care contains the same care providers over time, individual adjustments and competent care providers and do not differ from the general Swedish population. Interpersonal interaction is a hallmark of nursing care and other healthcare disciplines. Ideally, interpersonal care is achieved when individual care providers have few care receivers, which promote continuity in care, individual adjustments based on the care receivers individual needs and care providers with professional and relational competence.

Struggling between a sense of belonging and a sense of alienation: Residents' experiences of living in a residential care facility for older people in Sweden

Living in residential care facilities for older people is described in both positive and negative terms. To maintain care quality of a vulnerable group in a constantly changing care context, it is important to continually describe their experiences. This qualitative study aims to describe residents’ experiences of living in a residential care facility for older people in Sweden. Six residents were interviewed and the interviews were analyzed using qualitative content analysis. The analysis resulted in nine sub-categories, two categories and one overall theme. Living in a residential care facility for older people is revealed as ‘Struggling between a sense of belonging and a sense of alienation’. It is of great importance for care providers to explore and try to understand what individuals perceive as factors for feelings of belonging, thereby preventing alienation.

Meaning of home and health dynamics among younger older people in Sweden

Research has shown that positive evaluations of home are important for very old people’s health, well-being and independence in daily life. The rationale for the present study derives from our survey study findings, confirming such associations also in a younger cohort (N = 371). The purpose of this study was to further increase the understanding of the dynamics of meaning of home and health among community-living healthy younger older people, in the present and in a projected future. Data were collected through semi-structured interviews with 13 persons aged 67–70 years living in ordinary housing in Sweden, followed by a qualitative content analysis. Findings suggest that the home becomes progressively important after retirement. Not only the immediate home environment but also local neighbourhoods influence perceptions about home. Home brings emotional and social benefits but also worries about how to cope with complex home ambivalence when reflecting upon future housing arrangements. The findings suggest that it is important to consider the role of perceived aspects of home for health and well-being in early phases of the ageing process. The findings could be used to raise awareness among policymakers, housing authorities and professionals involved in housing-related counselling.

Cohort and education as predictors of temporary employment, and their relation to low wages and socioeconomic classification for young people in Sweden

ABSTRACTThe purpose of my paper is to describe and explain the probability of staying in temporary work for young people (age 16–27) in Sweden between 1992 and 2011 and its relation to socioeconomic outcomes (low socioeconomic classification and wage). I used panel data from the Swedish Labour Force Survey (LFS) and the longitudinal integration database for health insurance and labour market studies (LISA). To analyse the data, I used a dynamic probit model, unconditional quantile regression, and a pooled bivariate probit model. My results suggest that young people who have a low education have lower probabilities of receiving temporary employment in younger cohorts. However, younger cohorts with a lower education have a substantive wage disadvantage, specifically in younger cohorts compared to older cohorts. Low-educated cohorts also have a higher probability of obtaining low socioeconomic classification (SEC) employment, which is conditional on holding temporary employment in older cohorts compared to other educational groupings.

Strengthening Adolescent Wellbeing project—Qualitative outcomes from a pilot in a Swedish upper-secondary school

While a majority of Swedish school children enjoy a good health, mental health problems are increasing among young people in Sweden. According to Swedish law all school staff members (teachers and student health professionals) have mutual responsibility to provide a safe school environment and health. Since 2010, there is an emphasis on health promotion in schools. The aim of this study is to qualitatively describe the feasibility of a health-promoting intervention targeting healthy high school students (the Strengthening Adolescent Wellbeing [SAW] project). A descriptive design was used with an intervention group that was assessed before and after the implementation of the programme using quantitative methods. The study was based on the Medical Research Council Framework. The study and the data collection were performed during the autumn of 2016 and the early spring of 2017. Public high school students' health professionals (school nurses), student counsellors and specialist educators, facilitated a research-based intervention consisting of eight sessions with education and mind-body practices. Pre- and post-testing were carried out. The main findings showed that participating students and staff members were satisfied that the content and the implementation of the intervention were meaningful.

Well-being and Stress Among Upper Secondary School Pupils in Sweden

BackgroundThe psychological health of young people in Sweden has declined since measurements began to be taken in 1985. The reasons for the increase in stress and decline in psychological well-being among adolescents have been de- bated during the past few years.ObjectiveThe aims of this study were to explore: 1) pupils’ experience of stu- dent health services, family, friends, recuperation and the learning environment; 2) whether there is a difference between introverted and extroverted pupils’ sense of well-being, perceived stress, views of the learning environment, and relation- ships with friends and family; and 3) the degree to which the different aspects of school life predict well-being and stress.DesignData were collected by means of a web survey in which 1045 respond- ents participated.ResultsThe results showed that there are significant differences in percep- tions of well-being and stress depending on gender and the type of study program pupils were enrolled in. The results also revealed significant differences between introverts’ and extraverts’ relationships with family and friends, experience of the learning environment, and reported well-being and stress. A series of hierarchical linear regressions revealed that there were several factors affecting pupils’ report- ed well-being and stress. The learning environment and relationships with family and friends were significant predictors for both outcome variables. Pupils’ ability to recuperate from their work was found to be the most impactful predictor for well-being and stress.ConclusionOur results suggest that the way in which teachers interact with pupils is an important factor influencing pupils’ experience of well-being and stress. Furthermore, our results suggest that pupils would benefit from student health services being made more visible and pro-active in their interaction with students. (Less)

Optimal probability weights for estimating causal effects of time-varying treatments with marginal structural Cox models.

Marginal structural Cox models have been used to estimate the causal effect of a time-varying treatment on a survival outcome in the presence of time-dependent confounders. These methods rely on the positivity assumption, which states that the propensity scores are bounded away from zero and one. Practical violations of this assumption are common in longitudinal studies, resulting in extreme weights that may yield erroneous inferences. Truncation, which consists of replacing outlying weights with less extreme ones, is the most common approach to control for extreme weights to date. While truncation reduces the variability in the weights and the consequent sampling variability of the estimator, it can also introduce bias. Instead of truncated weights, we propose using optimal probability weights, defined as those that have a specified variance and the smallest Euclidean distance from the original, untruncated weights. The set of optimal weights is obtained by solving a constrained quadratic optimization problem. The proposed weights are evaluated in a simulation study and applied to the assessment of the effect of treatment on time to death among people in Sweden who live with human immunodeficiency virus and inject drugs.

Like a jar of flies? A study of self-control in an organizational social dilemma with large stakes.

We study the practice of self-control in an organizational social dilemma when the stakes are large, using 47 years of vital census data from 18th century Sweden. From 1750 to 1800, eighty percent of Sweden lived in a simple-structure organization called a bytvång or village commons. The amount of resources a village family received was a function of their size. During this period, crop failures left the population facing starvation. Using autoregressive time-series modeling, we test whether the people of Sweden continued to take steps toward increasing the stress on the commons by marrying and birthing children or practiced self-control. We find evidence that the peasantry–with little education, archaic agricultural practices, strong barriers to abortion and infanticide, and pressures by the Church and State to procreate–were less likely to marry and birth children (in or outside of wedlock) when the quality of the previous year’s harvest was poor compared to when it was bounteous. Post hoc analyses support the idea that the reason behind declining fertility after a famine was human decision rather than human physiology. Our findings are consistent with the idea that human population growth is not a social dilemma called a collective trap–which has been the assumption for 50 years. Rather, human population growth may be an individual dilemma–suggesting that members of simple-structured organizations can unilaterally exercise self-control and manage resources through self-organizing.