Swedish Context Research Articles

The politics of pretrial detention: Mapping the development of Swedish remand policy

Since the early 1990s, Sweden has received severe criticism from international human rights monitoring bodies for their pretrial detention regimes. Contrary to its acknowledged humane prison conditions, the majority of individuals held on remand are confined in conditions that resemble solitary confinement. While all Nordic countries have received similar criticism, Sweden has been argued to have done the least to change their remand practices. This article provides an in-depth analysis of the development and political processes that has shaped Swedish remand policy since the establishment of the 1948 Swedish Code of Judicial Procedure and the 1958 Act on Detention. The article shows that despite political concerns of the harms and infringements that the remand practices entail, the outcomes of reforms have been limited: due to administrative burdens, legal constraints, and increased punitive demands. The article elucidates the actors and conflicting agendas involved in shaping remand policy—of penal, political, humanitarian, administrative and legal nature—that are unattainable in structural analyses, and have application beyond the Swedish context and future in-depth examinations of developments in remand policy.

Parental Voices on Screen Time Guidelines in Early Childhood

This article critically engages with the concept of screen time. We explore the screen time recommendations from the World Health Organization (WHO) and their application in the Swedish context. We also investigate the experiences and opinions on the recommendations and advice on screen time and screen media use in early childhood among parents of young children (0–3 yrs.) in Sweden. The study draws from qualitative semi-structured interviews during multiple home visits from a diverse sample of 16 families. Findings are discussed through the prism of the ‘moral economy’ of the household and the ‘social imaginaries’ underpinning this. We have identified two types of approaches to guidelines on screen time among parents, and based on our findings we recommend organizations in Sweden and beyond, to rethink and revise the current guidelines, including the WHO recommendations.

Are early emotional and behavioral problems related to subsequent asthma in preschool children?

Abstract Background The most common mental health problems in preschool children are emotional and behavioral problems, and one of the most common chronic inflammatory diseases in children is asthma. Most research on the relationship between emotional and behavioral problems and asthma includes school-aged children. The current study aimed to explore the association between emotional and behavioral problems during preschool years and the risk of asthma in a Swedish context. Methods The study was a longitudinal cohort study, with 6954 children aged 3-5 years for which data on emotional and behavioral problems through the Strengths and Difficulties Questionnaire were collected in Uppsala Region, Sweden, between 2013 and 2017. The cohort was followed with data from the National Patient Register from 2013 to 2022. Asthma was defined as having at least three diagnoses (ICD-10 codes: J45-J46) during follow-up. Unadjusted and adjusted cox regression models were used to analyze data. Results A total of 269 children (3.9%) had diagnosed asthma during follow-up. Preliminary results show that children with emotional symptoms, rated separately by mothers (HR: 1.62, 95% CI: 1.20-2.20), fathers (HR: 1.49, 95% CI: 1.10-2.03), and preschool teachers (HR: 1.53, 95% CI: 1.08-2.16) had increased risk of being diagnosed with asthma according to unadjusted cox-regression models. In addition, children with total emotional and behavioural problems, rated by fathers (HR: 1.51 95% CI: 1.10-2.07) were also at higher risk of being diagnosed with asthma. These associations remained significant when adjusting for background and sociodemographic factors. Conclusions Our findings point to the significance of a clinical awareness of the relation between emotional and behavioral problems and asthma in young children. Our findings highlight the importance of also considering somatic problems, including asthma, in children with early signs of emotional and behavioral problems. Key messages • Emotional and behavioral problems in preschool children is related to being diagnosed with asthma. • Somatic problems, as asthma, needs to be considered in children with emotional and behavioral problems.

Students’ attitudes towards and willingness to intervene in partner violence against women in Sweden

Abstract Intimate partner violence against women (IPVAW) is a global public health problem, shown to be related to gender equality and to attitudes towards IPVAW. In Sweden, however, the reported prevalence of IPVAW is high, despite high levels of gender equality and a clear condemnation of such violence on the societal level. This phenomenon has been referred to as The Nordic paradox. One potential explanation for this paradox is that gender equality measures at the public level are not necessarily comparable to gender equality at a private level. One way to find out more about this is to investigate attitudes towards IPVAW at an individual level, which has so far been done to a limited extent in a Swedish context. In the current study, the aim was to investigate different aspects of attitudes to IPVAW (perceived acceptability, perceived severity, victim-blaming and ambivalent sexism) among university students in Sweden, and whether those attitudes were related to studentś willingness to intervene in cases of IPVAW. Any gender differences related to IPVAW attitudes and willingness to intervene were also examined. The respondents (n = 656, ≥18 years old) were recruited from three different universities and represented different scientific fields (e.g. social, behavioral, and technical sciences). Most of the respondents were undergraduate students and the majority were women (81%). The results showed that the students had rather non-accepting attitudes towards IPVAW overall, but viewed victims as to some extent responsible of the violence they are subjected to. There were no gender differences regarding willingness to intervene in cases of IPVAW, and attitudes to IPVAW were related to willingness to intervene. There were both similarities and differences between male and female students, in terms of how attitudes were linked to willingness to intervene. The presentation will discuss the results and their implications for future research, policy and practice. Key messages • Increased knowledge on attitudes towards IPVAW in Sweden may shed light on the Nordic paradox. • While non-accepting attitudes were found overall, gender differences and tendencies towards victim-blaming were identified.

Groundwater modelling for decision-support in practice: Insights from Sweden.

Groundwater is an essential resource for drinking water, food production, and industrial applications worldwide. Over-exploitation and pollution pose significant risks to groundwater sustainability. Groundwater models can be powerful tools for optimizing use, managing risks, and aiding decision-making. For this purpose, models should assimilate pertinent data and quantify uncertainties in outcomes. We examine applied modelling for characterization and decision support in Sweden from 2010 to 2023. We also review syllabi of water-related courses in Swedish higher education to assess the inclusion and extent of groundwater modelling education. We find that important academic advances in groundwater modelling over the past two decades have not translated into practical application within Sweden's industry, that uncertainty quantification is rarely undertaken, and that groundwater modelling remains a low priority in higher education. Based on these findings, we offer recommendations that, while informed by the Swedish context, hold relevance for educational institutions, industry, and decision-makers internationally.

Measuring Professional Governance: The Swedish Version of the Verran Professional Governance Scale©.

To translate the Verran Professional Governance Scale© (VPGS©) into Swedish, adapt it to the Swedish context, and validate it. Magnet®-recognized hospitals have proven successful in reversing negative trends regarding nursing shortage. A change in organizational and management structures is required, and professional governance is fundamental. However, in a Swedish context, there are no validated instruments to measure professional governance. The instrument was translated from English to Swedish and synthesized into a unified version. It was back translated, discussed in an expert panel, and pilot tested with cognitive interviews of nurses. A new Swedish version of the VPGS© was developed. The expert group reached a consensus, and the scale-level Content Validity Index value shows high relevance. Some words and sentences were revised, and an introduction was added. The study generated a Swedish version of the VPGS©, which can be used to measure nurses' perceptions of professional governance behaviors.

Translation and initial cross-cultural adaptation of the tool for support-gradual return-to-work for persons with chronic musculoskeletal pain to the Swedish setting.

A well-defined and clear procedure is a key factor supporting return-to-work and enhancing collaboration and understanding between employers and employees. The adaptation of the Tool for Support-Gradual Return to Work, TS-GRTW, addresses relevant cultural aspects valuable for wider adoption. develop a Swedish version, the GRTWswe, for implementation and integration into the Swedish labor market's RTW process. This involved translating, culturally adapting, and assessing the appropriateness and utility. In the initial step, a double back translation was performed to create an initial translated version. This version was then utilized in individual consultations, accompanied by an agreement questionnaire. For the subsequent step, group consultations were held to refine and customize the tool to suit the Swedish context. Ten occupational therapists completed the questionnaires, with mean agreement scores surpassing three on a four-point scale. Out of these, nine participated in group consultations. The findings suggest the requirement for specific modifications to the GRTWswe. These adaptations are essential because of cultural differences in organizational structures and reference frameworks. Moreover, participants unanimously agreed to broaden the scope of target groups, encompassing employees without regard for diagnosis and expanding the range of professions that can utilize this tool. This step aims to enhance the tool's applicability and usefulness. The study found strong alignment between questionnaire responses and group consultations outcomes, affirming the adapted tool's suitability for use in a Swedish context. The tool benefits employers and employees by enhancing communication, encouraging collaboration, and structuring processes, promising lasting improvements to work conditions.

Healthcare Professionals' Knowledge, Skills, and Information Needs Pertaining to Hearing Loss and Hearing Aids in Swedish Nursing Homes: A Cross-Sectional Study and Psychometric Evaluation.

Hearing loss increases with age and due to increased life expectancy there is an increase in the number of individuals living with hearing loss. Older people with hearing loss residing in nursing homes are often dependent on healthcare professionals to help them with their hearing aids. The aim of the study was to translate and test the psychometric properties of a Swedish version of a Norwegian questionnaire and to assess healthcare professionals' self-reported knowledge, experience, skills, competence, and information needs pertaining to residents' hearing loss and hearing aids in the Swedish context. A Norwegian questionnaire was translated and adapted, and thereafter distributed to healthcare professionals in nine nursing homes in mid Sweden between 2020 and 2021, and 313 questionnaires were returned. An exploratory factor analysis demonstrated adequate factorial structure in six factors, satisfying construct validity and internal consistency for the Swedish version. A confirmatory factor analysis showed a satisfactory model fit. Healthcare professionals reported having the skills required for handling hearing aids, but reported lower scores for having received information about hearing aids, taking initiatives to refer residents to hearing healthcare units, and checking for earwax. Registered nurses generally reported lower perceived knowledge and practical skills concerning hearing aids. Seventy-seven percent of the total group reported a need for information regarding hearing aid maintenance. Healthcare professionals reported that the majority of nursing home residents need help with their hearing aids, but only a minority of these professionals had received education on hearing loss and training in hearing aid maintenance. Enrolled nurses and care assistants demonstrated higher levels of competence in handling hearing aids compared to registered nurses. In order to ensure safe and effective care, as well as facilitate communication among older adults with hearing loss, healthcare professionals need appropriate education and training.

S14-1: EUPAP Feasibility Study. Practice transfer of a HEPA prescription model to other nine EU countries. From theory to practice

Abstract Purpose The Swedish Physical Activity on Prescription (PAP-S) method was to be transferred to other European regions through the EUPAP Project, innovative for implementing a reliable method to other nine countries. Implementation practices are strongly context-dependent; therefore, the practice transfer requires a flexible approach. PAP-S results over 20 years have reported success to a variety of populations. It addresses physically inactive individuals and/or with chronic conditions to improve their health by increasing their physical activity (PA) levels. The PAP-S five core components are: individualised patient-centred counselling, evidence-based PA recommendation, written prescription, community support, and follow-up. The goal was to know the context regarding PA prescription and ease the transfer from the Swedish context, specifically to: a) setting relevant PAP-S indicators for planning and monitoring, b) creating guidelines for data collection, c) providing an overview of the situation in each region, and d) assessing for readiness to implement the model. Project description Modified Hybrid e-Delphi process by representative from 10 countries. First, commitment from organisations to assume costs for the implementation. Second, description of variables and procedures for data collection. Data comprised two dimensions (ie, macro level (early diagnosis) and micro level (preparedness for implementation)). Third, data collection. Fourth, data analysis and discussion. Thirty-five experts participated in the EUPAP Feasibility Study. Guidelines for data collection includes indicators on macro level: a) EUPAP-relevant policy documents, b) profiles of prescribers and allied professionals, c) programmes, materials and training on HEPA, d) regulations, e) budget; and micro level: a) stakeholders, b) settings, c) agents, d) end-users. Country-specific results were collected, compared and discussed in relation to the core components of PAP-S (findings are accessible on www.eupap.org). Project partners disseminated the results among region-specific stakeholders. Conclusions Data showed regions with solid background to launch the EUPAP implementation (Flanders, Catalonia, Portugal) and others with less existing materials or weak network (Malta, Romania, Germany). Policy-makers, local health services and communities may better set short- mid- and long-term goals for the PAP-S transfer. Further design on practices and policies may use the Feasibility Study Guidelines for setting specific procedures. Funding Co-funded by the European Union’s Health Programme (2014-2020).

Pv-load matching based on combination of different consumers: A case study in Swedish contexts

The transition towards sustainability necessitates robust growth of renewable energy, especially solar power. However, increasing the shares of solar power may lead to mismatch of electricity supply and demand, thus worse solar power performance could be received due to lower self-consumption and self-sufficiency. This issue has attracted more attention recently as it also requires additional costs for controlling and battery integration. This study combines several load profiles from consumers having different behaviors with different proportions to find out the optimal shares with higher level of PV penetration and self-sufficiency. A visualizing matching layout is proposed to present the PV-load matching level of all the possibilities at different seasons based on a Swedish context. It is found an 8% improvement of self-sufficiency reaching 70% in summer without additional equipment and scarification of self-consumption. The results could assist in the design and planning of the future power sector. Regarding specific targets, various optimal solutions could be found based on the layout.

What makes employees and managers see eye to eye concerning organizational justice? Predicting congruence in the Swedish pay-setting context

What makes employees and managers see eye to eye concerning organizational justice? Predicting congruence in the Swedish pay-setting context

Psychometric properties and cut-off scores for the Swedish version of the Negative Acts Questionnaire: The full scale and short version.

The present study investigates the psychometric properties and cut-off scores of a Swedish version of the Negative Acts Questionnaire, the most frequently used instrument to measure exposure to workplace bullying. Based on a probability sample of the Swedish workforce (n = 1853), we investigate the validity of both the full version (NAQ-R) and the short version (SNAQ). We suggest optimal cut-offs for the NAQ-R and SNAQ, and for the subscales measuring work- and person-related bullying. Based on the cut-off scores we provide estimates of prevalence in a Swedish context. The factor structure and psychometric properties are comparable to the Norwegian original and the English versions of the instrument. We also tested the criterion validity using 11 outcome and antecedent variables to bullying, and all provided support for its validity. The identified cut-off scores differentiate clearly when tested against the 11 variables used to test criterion validity in the study. The results showed that the Swedish version of the NAQ-R, including the SNAQ, is a valid measure of workplace bullying. To our knowledge, this study is the first study presenting statistical cut-offs for the NAQ-R subscales as well as investigating both the NAQ-R and the SNAQ simultaneously. The present study also provides some criticism against and suggestions for improving the NAQ-R, aiming to capture even more of the overall experience of exposure, ability to defend oneself, overall duration, and on- and offline exposure.

Psychometric Evaluation of the Swedish Version of the Types of Positive Affect Scale

Abstract: Differentiating between various types of positive affect (PA), such as excitement, relaxation, safeness, and contentment, is important when assessing mental health. However, validated instruments measuring these types of PA are scarce, and in a Swedish context, they are nonexisting. Thus, the present study assesses the psychometric properties of the translated Swedish version of the Types of PA Scale (TPAS) using a sample of 440 Swedish adults. Corroborating previous research, confirmatory factor analyses supported a modified three-factor model (Activated PA, Relaxed PA, Safe/Content PA), showing good reliability, good convergent validity, and satisfactory discriminant validity of the factors. Furthermore, the TPAS demonstrates measurement invariance across demographics (age, gender, and education) and exhibits satisfactory construct validity by distinguishing between PA, NA and State–Trait Anxiety. Hence, the Swedish TPAS is a valid tool for measuring types of PA in the adult population of Sweden, with potential areas for improvement being discussed.

Symposium 1: Relationality, Networked Learning and Árbediehtu- traditional Sámi knowledge

The purpose with this paper is firstly to investigate whether an Indigenous, multidimensional, relationally intertwined onto-epistemology is present in a policy document regarding árbediehtu, traditional Sámi knowledge. The policy identify knowledge claims the Sámi parliament in Sweden wants to pass on to future generations, and is the closest to a Sámi produced curriculum we get in a Swedish context. A four-dimensional relational framework where relationality is unpacked through resonance theory by Hartmut Rosa is utilised as an analytical tool. Secondly, implications for Networked Learning, especially as occurring in remote Sámi language education, are elaborated on. The findings show that the framework can be helpful for understanding and describing a multidimensional relational onto-epistemology as relationships in the policy can be identified on three of the four dimensions in the framework. The last dimension involves the self and is mainly a reflexive tool. However, as the discussion initiated in the concluding section indicates, implications for Networked Learning and remote Sámi language education is not the only take-away. An unpacked understanding of relationality offers a glocalised as-well-as theoretical approach, which is important both locally and globally as issues of sustainability call for the development of a new social contract. According to resonance theory, resonant relationships are transformational, leading to the conclusion that a relational approach can lead to an increased understanding of learning and knowing, and a sense of self-efficacy and a stronger identity, all important aspects in transformational education. Further, the study is an example of how a national graduate school, GRADE, can offer epistemic space when researching digital technologies in education.

Quality improvement development in Swedish healthcare and welfare services

PurposeQuality improvement has developed and spread, and today, all Swedish Regions emphasize that their strategies are based on systematic improvement. This paper aims to describe and illuminate the development of Quality Improvement (QI) in Swedish healthcare and welfare organizations by using publications in a Swedish context.Design/methodology/approachThe overview synthesis is inspired by a scoping literature review approach of relevant literature. All publications relevant to Swedish healthcare and welfare settings between 1992 until 2020 were included.FindingsIn all, 213 papers, 29 books and chapters and 34 dissertations related to QI and research in Swedish healthcare and welfare context were identified. From 2011 to 2020, the publication rate increased rapidly. Six different focus areas emerged: systematic and value-creating improvement work; collaboration between organizations and healthcare providers; use of improvement methods and (theoretical) models; leadership and learning; measurements, quality registers and follow-up; and involvement and patient safety. Further QI development in Swedish healthcare and welfare points to an increased importance of collaboration between organizations and coproduction with beneficiaries for the healthcare and welfare services.Originality/valueThis paper is one of the first to describe and illuminate the QI development in the healthcare and welfare sector in a country. The trajectory also points to a need for coproduction to handle future challenges.

Evaluation of the Teaching Recovery Techniques intervention among newcomer students in Swedish schools: a randomised controlled trial turned into a feasibility study

BackgroundDuring recent years, Europe has faced the arrival of migrants whereof a considerable group of youth present mental health problems, such as symptoms of post-traumatic stress disorder (PTSD). Schools offer a safe environment for mental health interventions to these groups, yet there is limited research on the impact of school-based interventions addressing mental health problems in newcomer youths, especially in the Swedish context. This cluster randomized controlled trial (RCT) aimed to explore the effectiveness of the Teaching Recovery Techniques (TRT) intervention among newcomer students with PTSD symptoms in Swedish secondary schools.MethodsNine schools were randomly assigned to TRT or a wait list control group prior to the baseline assessment. Follow-up data were collected immediately following the intervention and three months post-intervention. In total, 531 students were approached, of which 61 gave consent and were eligible to be included in the study: 55 in TRT and 6 in the control condition. Given the low number of participants in the control condition, we merely analyzed students who had received TRT.ResultsWe report on feasibility of recruitment, data collection, intervention delivery and intervention effectiveness. In terms of intervention effectiveness, within subjects ANOVAs revealed significant reductions in PTSD symptoms and general mental health problems from baseline to the three months-follow-up (p < 0.001).ConclusionsOur results indicate that TRT is a promising school-based intervention for newcomer students with PTSD symptoms. For a successful implementation of TRT in the school context, schools need to be engaged and the implementation should be managed by a local coordinator.Trial registrationISRCTN, ISRCTN48178969, Retrospectively registered 20/12/2019.

When Cows Become Heroes: The Construction of Animal Subjectivity and Environmental Sustainability in the Swedish Organic food Sector

An escalating consumption of animal products characterizes contemporary Western society, resulting in severe environmental consequences and heightened exploitation of animals. Among these issues, livestock production stands out as particularly detrimental due to its significant climate impact and land usage. Paradoxically, the Swedish organic food sector positions cattle as central to achieving sustainable food production. This article delves into the strategies employed by organic organizations to legitimize the consumption of cattle’s meat and dairy. The aim is to examine how Swedish organic organizations produce knowledge of sustainability, and how these sustainability constructions are intertwined with anthroparchy, a system of power relations between humans and cattle. Furthermore, the study investigates how cattle’s agencies and bodies are portrayed. Interviews, documents and media material from organic organizations in Sweden are analyzed to explore how carnism, norms of eating cattle’s meat and dairy, is maintained. The analytical framework applied is rooted in critical animal studies and draws inspiration from Foucauldian discourse analysis, examining the interplay between power and knowledge. The findings reveal that certain environmental aspects are emphasized to reinforce the norm of keeping cattle for food production, while other dimensions are overlooked. Organic organizations represent cows as active subjects transforming their environment to legitimize their status as consumable commodities. The findings also show how carnistic norms limit the organic sector’s ability to achieve environmental objectives. This study underscores how anthroparchy, the dominant power structures between humans and cattle, is reproduced in the Swedish organic context through sustainability discourses that emphasize the subjectivities of cattle.

P-783 Factors associated with donor-conceived adolescents’ intention to request information about their open-identity oocyte or sperm donor

Abstract Study question Is adolescents’ intention to request information about their open-identity donor associated with donor type, family form, or adolescent gender? Summary answer Adolescent girls were less likely than boys to intend requesting information about their open-identity donor, irrespective of donor type (oocyte/sperm) and family form. What is known already Individuals conceived by open-identity gamete donation have the right to obtain identifying information about their donor. However, there is little knowledge about the level of interest in requesting such information as donor conceived (DC) persons approach the age when they can obtain this information, as well as their interest in contact with the donor and persons who share the same donor. The present study aims to investigate factors associated with adolescentś intention to request information about their open-identity donor and their interest in contact with the donor and donor-siblings. Study design, size, duration The study is based on the fifth wave of data collection in the prospective, longitudinal Swedish Study on Gamete Donation, conducted in 2022-2023. Participating parents provided consent to contact their donor conceived children (ages 13-16), who were approached with a postal/web-survey. A total of 98 adolescents participated (77% response rate): adolescents conceived with sperm donation in lesbian-couple (SD-lesb, n = 48) and heterosexual-couple families (SD-het, n = 27), and those conceived with oocyte-donation in heterosexual-couple families (OD-het, n = 23). Participants/materials, setting, methods The study was part of the longitudinal Swedish Study on Gamete Donation, including couples starting gamete donation treatment at university hospitals between 2005-2008. The current fifth wave of data collection is the first to include children self-report. Participating adolescents included 48 girls and 50 boys with a mean age of 14.44 for girls and 14.28 for boys. The survey comprised of socio-demographics, study-specific items and validated instruments. Data was analyzed with multinominal regression analysis. Main results and the role of chance Roughly half (56%) of the adolescents intended to request information about their open-identity donor, while 12% planned not to and 32% were unsure. Multinominal regression analysis showed a significant effect for gender, but not for family/donation type (SD-lesb, SD-het, OD-het). Girls were significantly more likely than boys to state that they did not intend to request donor information (OR = 4.66, 95% CI [1.13, 19.34]). Among those adolescents who planned to request identifying donor information, a subset stated that they intended to contact the donor (30% boys, 15% girls). Concerning interest in contact with persons who share the same donor, participants were evenly divided between an interest (29%) or no interest (27%) and remaining were unsure (44%). No differences were found with regard to groups or gender. Limitations, reasons for caution The relatively small sample size could affect the results of the statistical analysis, making it harder to get significant results and creating large confidence intervals. There is a possible attrition bias with less well-functioning families not participating. The study was conducted within the Swedish context of identity-release gamete donation. Wider implications of the findings Approaching adulthood, about half of donor-conceived individuals plan to request information about their open-identity donor, highlighting that many DC people want this possibility. The gender difference found contrasts with earlier research findings and points to the need to understand the specific motivations of different groups of DC adolescents. Trial registration number not applicable

Behind the scenes of doctoral success: a mixed methods approach to exploring PhD supervision courses in Swedish higher education institutions

ABSTRACT Doctoral education is a critical mission of higher education institutions (HEIs), and supervisors of PhD students have a prominent role in the process. The relevance of their role in a successful PhD experience and outcome raises an important question: how are PhD supervisors trained for their roles in the doctoral education process? In this work, we aimed to identify the formal training components in the syllabi of PhD supervision courses in Swedish HEIs. Accordingly, we used a mixed methods approach to thematic analysis to uncover themes in the publicly available syllabi of PhD supervisor courses followed by a quantification of the themes’ appearance per syllabi. Swedish higher education constitutes an ideal context for this study as most universities in Sweden require their faculty members to undertake a supervisory course before starting their supervisory activities. Our analysis showed that reflective practices, inclusive supervision, and the formal guidelines and processes of doctoral education were among the preeminent themes in PhD supervision courses. In conclusion, this study reveals the critical elements of PhD supervision courses in the Swedish HEI context and contributes to knowledge about the formal training of PhD supervisors by universities; therefore, it can potentially inform changes in the frameworks and practical design of such courses worldwide.

Factor structure of FUNDES-Child-SE measuring the participation and independence of children with disabilities.

FUNDES-Child-SE is a proxy rating questionnaire for measuring participation and independence in children with disabilities in a Swedish context. It includes the components of frequency of attendance, engagement and independence. The original, Taiwanese FUNDES-Child 7.0, has previously been found to have a four-factor structure for frequency of participation and a two-factor structure for independence. The aim of this study was to test the factor structure in FUNDES-Child-SE. The factor structure is an important part of construct validity. Caregivers of 163 children with disabilities aged 6-18 years participated in this cross-sectional study. Exploratory factor analysis was used to find the factor structure for Engagement. Confirmatory factor analysis was used to test the factor structure for all three components. The proposed factor structure for frequency of participation (daily living participation frequency, mobility participation frequency, learning participation frequency and community participation frequency) and independence (daily living independence and social participation independence) fit with data from FUNDES-Child-SE after excluding three to five items and adding two to five covariances of residuals. In the engagement component, two factors, named engagement in informal activities and engagement in formal activities, were found. After excluding one item and adding 10 covariances of residuals, the factor structure had an acceptable fit to data. Differences in components' factor structure indicate that attendance and engagement are separate aspects of participation. Before using numeric scores from FUNDES-Child-SE in clinical settings, responsiveness and interpretability should be evaluated.