Rheumatic diseases are often chronic and involve a lifetime of suffering. The focus of rheumatology care is to support patients to manage their lives and master their disease. Healthcare providers and patients have different views on the consequences of living with rheumatic diseases and patients are reporting unmet healthcare needs. There is a need to integrate providers’ perspective to develop the quality of rheumatology care. The aim was to explore healthcare providers’ experiences of their interaction with patients in their management of RA. Interviews with 18 providers from different clinical settings were analysed in accordance with the grounded theory method. A core category; Delivering knowledge and advice was found to be the most important task and involved providing the patient with information about the disease and appropriate forms of treatment. Healthcare providers’ attitudes and patients’ responses influenced the outcome of the delivery of knowledge and advice and three dimensions emerged; completed delivery, adjusted delivery and failed delivery. There were differences in the providers’ experiences in their interaction with patients as well as in reflections on their role as the delivering part. There could be difficulties in the interaction when patients’ expectations and preferences were not taken into account when giving advice. These findings highlight the importance of developing rheumatology care, as no provider or patient benefits if the delivery of knowledge and advice becomes a failed delivery. The healthcare organization must acknowledge the difficulties involved in the interaction with patients in their management of RA and find methods to develop a more person-centred approach to care.

Purpose: This study focuses on higher education as a pathway to establishment in a new society for female immigrants and its role in well-being. Building on previous research that highlights social capital and empowerment as significant factors for successful establishment in a new society, and experiencing well-being, this study aims to explore if higher education can promote female immigrants’ establishment in Swedish society. Methods: Interviews were used to explore female immigrants’ experiences of higher education and establishment in Swedish society. Thematic analysis was used to analyse the empirical material, generating a nuanced understanding of the studied topic. Results: Higher education was found to promote establishment in Swedish society, ultimately leading to an experience of well-being. Pursuing higher education was perceived as a means of achieving personal fulfilment and success while fostering new social connections. Important factors in pursuing higher education included favourable living conditions, personal motivation, and a positive educational attitude. Conclusion: The study provides insights into female immigrants’ higher education experiences in a context that promotes establishment in Swedish society and well-being. However, more research is needed to fully investigate the driving factors for female immigrants pursuing higher education, considering their migrant background and living conditions. © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

BOOK REVIEW: Constructing grounded theory. A practical guide through qualitative analysis Kathy Charmaz, 2006, 208 pp. London: Sage. ISBN 2005928035

Background: Early labour is the very first phase of the labour process and is considered to be a period of time when no professional attendance is needed. However there is a high frequency of women who seek care at the delivery wards during this phase. When a woman is admitted to the delivery ward, one role for midwives is to determine whether the woman is in established labour or not. If the woman is assessed as being in early labour she will probably then be advised to return home. This recommendation is made due to past research that found that the longer a woman is in hospital the higher the risk for complications for her and her child. Women have described how this situation leaves them in a vulnerable situation where their preferences are not always met and where they are not always included in the decision-making process.

Aim: The aim of this study was to generate a theory based on where a woman chooses to be during the early labour process and to increase our understanding about how experiences can differ from place to place.

Methods: The method was a secondary analysis with grounded theory. The data used in the analysis was from two qualitative interview studies and 37 transcripts.

Conclusion: The findings revealed a substantive theory that women needed to be in a safe and thus secure place during early labour. This theory also describes the interplay between how women ascribed their meaning of childbirth as either a natural live event or a medical one, how this influenced where they wanted to be during early labour, and how that chosen place influenced their experiences of labour and birth.

Purpose: Becoming a mother is related to increased demands for women with type 1 diabetes mellitus, and more research is needed to identify their needs for support in everyday living. Thus, the aim of this study was to explore the main concerns in daily life in early motherhood for women with type 1 diabetes and how they deal with these concerns. Method: A grounded theory study was conducted in which 14 women with type 1 diabetes were interviewed individually 7 to 17 months after childbirth. Results: A conceptual model was identified with the core category “reprioritizing life”, and three related categories: adjusting to motherhood, taking command of the diabetes, and seeking like-minded women. Becoming a mother was a turning point towards a greater awareness and acceptance of prioritizing diabetes management and health, and thus, life. There was a gap in provision of diabetes care after birth and during the time of early motherhood compared with during pregnancy. Conclusions: Healthcare contacts already planned before delivery can promote person-centred care during the whole period from pregnancy to motherhood. Moreover, providing alternative sources for health information and peer support could improve the life situation during early motherhood. © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

Undertaking research studies in the field of mental health is essential in mental health nursing. Qualitative research methodologies enable human experiences to become visible and recognize the importance of lived experiences. This paper argues that involving people with schizophrenia in research is critical to promote their health and well-being. The quality of qualitative research needs scrutinizing according to methodological issues such as trustworthiness and ethical standards that are a fundamental part of qualitative research and nursing curricula. The aim of this study was to critically review recent qualitative studies involving people with severe and persistent mental illness such as schizophrenia and other psychotic conditions, regarding descriptions of ethical and methodological issues in data collection and analysis. A search for relevant papers was conducted in three electronic databases, in December 2016. Fifteen qualitative interview studies were included and reviewed regarding methodological issues related to ethics, and data collection and analysis. The results revealed insufficient descriptions of methodology regarding ethical considerations and issues related to recruitment and sampling in qualitative interview studies with individuals with severe mental illness, putting trustworthiness at risk despite detailed descriptions of data analysis. Knowledge from the perspective of individuals with their own experience of mental illness is essential. Issues regarding sampling and trustworthiness in qualitative studies involving people with severe mental illness are vital to counteract the stigmatization of mental illness.

BACKGROUND: Mental ill health among children and adolescents has increased worldwide. Mental health difficulties from a young age are associated with school absence and educational underachievement. A holistic perspective of treatments besides medical treatment is essential Thus, there is a need for research regarding equine-assisted intervention (EAI).

PURPOSE: The present study aimed to understand the outcomes of an equine-assisted intervention for children and adolescents with mental ill health from the perspectives of parents and close relatives.

METHODS: This study used a qualitative research design informed by Charmaz's Grounded Theory, with a purposive sample including six in-depth interviews.

RESULTS: The theory "building up bit by bit" was constructed, explaining the recognition that their children/adolescents were built up bit by bit and created a stronger self-identity. The participants referred to changes in the child's or adolescent's way of being and emotional regulation, which constituted building blocks leading to the child's or adolescent's increased Harmony, enhanced Self-identity, and improved Capability.

CONCLUSION: Parents and close relatives experienced that their child or adolescent was built up bit by bit and gained a stronger foundation to stand on. This led to increased harmony in everyday life with stronger self-worth, better performance, and reduced school absenteeism.

Background: In nursing and midwifery, the concept of environment is considered a meta-concept. Research findings suggest that the location is not the only important factor, as both place and space influence the practices of midwives. Moreover, research on the geography of health suggests a connection between place and health that could be extended to reproductive health. Therefore, to move beyond and expand traditional research expressions, it is beneficial to illuminate the concepts of place and space in relation to childbirth.

Purpose: This study was undertaken to produce a synthesis of previous qualitative research of issues in childbirth in relation to the concepts of place and space.

Method: In this Critical Interpretive Synthesis (CIS), four electronic databases; CINAHL, Medline, PsycINFO and Sociological abstracts, were used for the literature search. In total 734 papers were screened, and 27 papers met the final inclusion criteria after assessment.

Results: The synthesis reveals a need to create a space for childbirth underpinned by four aspects; a homely space, a spiritual space, a safe space, and a territorial space.

Conclusion: Findings from this review will provide a basis for useful dialogue in midwifery education and in clinical settings. © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Purpose: Digitalization and e-health have potential to generate good quality, equal health, well-being and to develop and strengthen individuals’ resources with the goal of increased independence and participation in society. The implementation of welfare technology requires knowledge of digitalization, as well as an awareness of its meaning in terms of ethical principles and ethical analysis. The purpose of this study was to describe ethical analysis concerning the implementation of welfare technology, in terms of both strategies and tools, within areas of social services in a Swedish municipality.

Method: We followed a working model that focused on increased knowledge and experience in the implementation of welfare technology from an ethical perspective. In the data collection were observations, a questionnaire with open-ended questions and focus group discussions used.

Results: The analysis showed that when welfare technology was introduced and implemented within the area of social services in a municipality, ethical awareness resulting from the conflicts between various interests and values had to be addressed.

Conclusions: The ethical analysis improved implementation of strategies and tools in terms of facts and values, and invisible underlying values to the concept of well-being. © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Earlier research has shown that power relationships at workplaces are constructed by power structures. Processes related to power always influence the working conditions for (in this study in elderly care) the working groups involved. Power structures are central for intersectional analysis, in the sense that the intersectional perspective highlights aspects such as gender and ethnicity (subjective dimensions) and interrelates them to processes of power (objective dimension). This qualitative study aims to explore in what way an intersectional perspective could contribute to increased knowledge of power structures in a nursing home where the employees were mostly immigrants from different countries. By using reflexive dialogues related to an intersectional perspective, new knowledge which contributes to the employeés well-being could develop. Narrative analysis was the method used to conduct this study. Through a multi-stage focus group on six occasions over six months, the staff was engaged in intersectional and critical reflections about power relationship with the researchers, by identifying patterns in their professional activities that could be connected to their subjectivities (gender, ethnicity, etc.). The result of this study presents three themes that express the staffs experiences and connect these experiences to structural discrimination. 1. Intersectionality, knowledge and experiences of professionalism, 2. Intersectionality, knowledge and experiences of collaboration, 3. Intersectionality, knowledge and experiences of discrimination. The result demonstrates that an intersectional perspective reinforces the involved abilities, during the conversations, into being clear about, for example, their experiences of discrimination, and consequently developing a better understanding of their professionalism and collaboration. Such deeper reflections became possible through a process of consciousness-raising, strengthening the employee’s self-confidence, in a positive way. © 2016 M. Cuesta.

Mental illness is increasing worldwide, while a trend towards an ever more specialized health care takes place. This development creates great demands on nurses to work from a holistic perspective of nursing. The health perspective emphasizes cooperation and communication with those who suffer from long-term mental illness, focusing on their independence and health. From a health perspective, every human being is an actor in his/her own life with an inherent ability to make their own choices. However, persons who suffer from long-term mental illness are at risk of losing power and control over areas of their lives and their health. Mental health nurses are in position to support these persons in promoting health and to regain control over their lives. The emphasis of this paper is thus to discuss mental health nurses responsibility to provide health promoting nursing care, through interpretation of the concepts of empowerment, emancipation, self-efficacy and self-management how can mental health nurses work from a health-promoting perspective in relation to these concepts. The focus of this paper is the challenge of real health promotion in mental health nursing discussed at a workshop at the European Horatio festival in Stockholm 2012 with over 600 participating mental health nurses and researchers from European countries. © 2014 P. D. Jönsson et al.

Epidemiological research has so far failed to explain the high incidence of occupational disorders among home care workers (HCWs) and the great differences in organizational incidence rate. A qualitative approach may contribute to a deeper understanding of work group reasoning and handling in a more contextual manner. The aim of this grounded theory study was to gain a deeper understanding of the main concern in the processes of recognizing, communicating and reporting occupational disorders among HCWs. Focus group interviews were conducted with 40 HCWs in 9 focus groups. The selected municipalities represented variations in municipality type and incidence rate of occupational disorders. Making it work in the frontline was identified as the core category explaining that the perceived work situation in home care work was the main concern but interacted with work-group socialising processes as well as with the communicability and derivability of the occupational disorder when defining and reporting occupational disorders. Complex problems could be reformulated and agreed within the workgroup to increase communicability. Described significances for reporting/non-reporting were related to financial compensation, to a part of organizational political game or to an existential uncertainty, i.e. questioning if it belonged to their chosen work and life. Our conclusion is that working situation and work group attitudes have importance for reporting of occupational disorders. To support work-related health for HCWs, integrating communication should be developed about work-related challenges in work situation, as well as about attitudes, culture and efficiency within work-group.

PURPOSE: Many municipalities today, together with other stakeholders, offer group exercises for the older population via municipal meeting places, focusing on promoting good health. During the Covid-19 pandemic, these group exercises either continued in a modified form or ceased. The aim of this study was to explore involved stakeholders' experiences of group exercises for older persons arranged via municipal meeting places during the Covid-19 pandemic. METHODS: Six online focus group interviews were conducted with 25 stakeholders, such as decision-makers and representatives from the non-profit sector, from seven municipalities in Sweden. Data were analysed using thematic analysis. FINDINGS: The collaboration around the group exercises was challenged due to affected communication and decision-making. The stakeholders described the importance of adapting and finding new ways to offer group exercise. Furthermore, the re-arranging of group exercises created concerns about the well-being of the older persons but also happiness with the older persons ability to act for their own well-being during the pandemic. CONCLUSIONS: This study highlights the importance of the municipalities exchanging experiences, making the older persons more involved in the decision-making process, enabling a person-centred encounter with the older persons when exercising in groups, and strengthening supportive environments by sharing the ownership of arranging the group exercises with the older persons.

AIM: To explore HPs' perceptions of working on lifestyle management for patients with early rheumatoid arthritis (RA). METHODS: In this qualitative study, individual interviews were conducted with 20 HPs. Qualitative content analysis was used, and three categories and six subcategories were identified. RESULTS: HPs' perceptions of working on lifestyle management for patients with early RA revealed a need for commitment from different levels. This included commitment from healthcare managers and organizations prioritizing work on lifestyle management and providing competence development for HPs. Commitment within the team regarding coordination of interdisciplinary teamwork and development of a structured lifestyle management approach, and commitment to involving patients in lifestyle management, by facilitating patient engagement and a person-centred approach. CONCLUSIONS: HPs' perceptions of working on lifestyle management for patients with early RA revealed that commitment from healthcare managers, organizations, and the interdisciplinary team was essential to facilitate collaboration, patient involvement, and a person-centred approach. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

In recent years, a number of studies have demonstrated that stress and mental health problems have increased among adolescents and especially among girls, although little is still known concerning what girls experience in their everyday lives. The aim of this study was to describe the phenomenon of teenage girls’ everyday lives, as experienced by the girls themselves. A phenomenological approach of reflective lifeworld research was used, and the findings are based on eight qualitative interviews with girls aged 13–16 years. The essence of teenage girls’ everyday lives as experienced by the girls themselves can be described as consciousness regarding demands and unfairness and regarding the importance of connectedness and security. The girls are aware of the demands of appearance and success, and they are conscious of the gender differences in school and in the media that affect them. The girls are also conscious about the meaning of connectedness with friends and family, as well as the importance of the security of their confidence in friends and feeling safe where they stay. If teenage girls feel connected and secure, protective factors in the form of manageability and meaningfulness can act as a counterweight to the demands and unfairness of everyday life. For professionals who work with teenage girls, the results from this study can be important in their work to support these girls.

Xerostomia, the subjective sensation of dry mouth, is associated with qualitative and quantitative changes of saliva. Poor health, certain medications and radiation therapy constitute major risk factors. To gain further understanding of this condition the present study explored the main concern of xerostomia expressed by affl icted adults. Qualitative interviews were conducted with 15 participants and analysed according to the grounded theory method. An aggravating misery was identi-fi ed as the core category, meaning that the main concern of xerostomia is its devastating and debilitating impact on multiple domains of well-being. Professional consultation, search for affi rmation and social withdrawal were strategies of management. The fi ndings reveal that xerostomia is not a trivial condition for those suffering. Oral impairment as well as physical and psychosocial consequences of xerostomia has a negative impact on quality of life. There is an obvious need to enhance professional competence to improve the compassion for and the support of individuals affl icted by xerostomia

Purpose: The aim of this study was to describe relatives’ experiences of an equine-assisted intervention for people with psychotic disorders.

Methods: The study has a qualitative and descriptive design. Ten semi-structured interviews were performed with relatives of people with a psychotic disorder who had participated in an equine-assisted intervention. A conventional content analysis was used to analyse the data.

Result: The overall category “Being with the horses strengthens health capabilities” summarizes the four identified subcategories “The horses contribute to a context with a common focus”, “Interaction with the horses enhances self-confidence and motivation”, “The interplay with the horses nurtures positive emotions” and “Being with the horses encourages physical activity”.

Conclusions: The result of this study contributes to the growing body of research about the potential outcomes of equine-assisted interventions. The result also indicates that equine-assisted interventions may improve health capabilities among people with psychotic disorders. The generated knowledge may be useful in mental health services when developing equine-assisted interventions. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Children’s right to participate in their own healthcare has increasingly become highlighted in national and international research as well as in government regulations. Nevertheless, children’s participation in healthcare is unsatisfactorily applied in praxis. There is a growing body of research regarding children’s participation, but research from the children’s own perspective is scarce. The aim of this study was thus to explore the experiences and preferences for participation in healthcare situations among children with juvenile idiopathic arthritis (JIA) as a foundation for creating strategies to promote their participation in pediatric healthcare. Twenty children, aged 8 to 17 years, with JIA were interviewed individually and in focus groups. In order to increase the children’s opportunities to express their own experiences, different interview techniques were used, such as draw-and-tell and role play with dolls. The analysis was conducted with a constructivist grounded theory. The result explores children’s perspective of influencing processes promoting their participation in healthcare situations. The core category that emerged was, “Releasing fear and uncertainty opens up for confidence and participation,” and the categories related to the core category are, “surrounded by a sense of security and comfort,” and “strengthened and supported to become involved.” In conclusion, the knowledge gained in this study offers new insights from the perspective of children themselves, and can constitute a valuable contribution to the understanding of necessary conditions for the development of specific interventions that promote participation among children in healthcare situations.

Background: Shared decision-making (SDM) is an emergent research topic in the field of mental health care and is considered to be a central component of a recovery-oriented system. Despite the evidence suggesting the benefits of this change in the power relationship between users and practitioners, the method has not been widely implemented in clinical practice.

Objective: The objective of this study was to investigate decisional and information needs among users with mental illness as a prerequisite for the development of a decision support tool aimed at supporting SDM in community-based mental health services in Sweden.

Methods: Three semi-structured focus group interviews were conducted with 22 adult users with mental illness. The transcribed interviews were analyzed using a directed content analysis. This method was used to develop an in-depth understanding of the decisional process as well as to validate and conceptually extend Elwyn et al.’s model of SDM.

Results: The model Elwyn et al. have created for SDM in somatic care fits well for mental health services, both in terms of process and content. However, the results also suggest an extension of the model because decisions related to mental illness are often complex and involve a number of life domains. Issues related to social context and individual recovery point to the need for a preparation phase focused on establishing cooperation and mutual understanding as well as a clear follow-up phase that allows for feedback and adjustments to the decision-making process.

Conclusions and Implications for Practice: The current study contributes to a deeper understanding of decisional and information needs among users of community-based mental health services that may reduce barriers to participation in decision-making. The results also shed light on attitudinal, relationship-based, and cognitive factors that are important to consider in adapting SDM in the mental health system.

Purpose: Parkinson’s disease (PD) is associated with motor and non-motor symptoms that negatively influence the person’s quality of life. To reduce illness and increase quality of life, alternative treatments of PD such as dance might be experienced as beneficial. The aim of this study was to explore experiences of how a dance program in Sweden influences perceived physical, social, and emotional wellbeing in persons with PD. Method: A qualitative method with semi-structured interviews and content analysis was used, and 10 participants with variations in age, gender, and how long they had been diagnosed with the disease were interviewed. Results: The results showed that dancing was experienced as improving health, which implied feeling both calmed and excited, getting better sleep, and being able to move with more focus and freedom. The dance program was experienced as a social context through the importance of community, feelings of togetherness, and being able to compare oneself with others. Experiences of self-support included experiencing increased self-esteem and joy, but also a sense of being confirmed and having structure, which gave meaning to everyday life. Conclusions: To reduce illness and increase quality of life in persons with PD, it is important to investigate alternative treatment methods, and this study shows the importance of participating in a dance program in Sweden for the life situation and health of people with PD. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Approximately 40 years ago, Barney Glaser and Anselm Strauss and their joint research approach, the constant comparative method of grounded theory, were at the forefront of what can be called a qualitative revolution. The publication of their book, The discovery of grounded theory (1967), was a breakthrough because of the systematic procedures for qualitative research that were presented. Prior to this publication, qualitative research methodology was traditionally most often taught orally. Through their book, Glaser and Strauss defended the method of qualitative research and countered the prevailing opinion that quantitative research provided the one and only approach to scientific inquiry. They argued that qualitative research is a field of inquiry in its own right, not merely to be used for pre-studies to “real” statistically based studies. The grounded theory method fits in with life world research, because the emphasis is on individuals as unique living wholes and the researcher focuses on the world as it is experienced by the individual. The researcher does not formulate any hypothesis in advance and tries to approach the research area with as few preconceptions as possible. Preconceptions, taken-for-granted assumptions, and interpretations must be handled by reflexive strategies in line with what Dahlberg (2006) has labelled “bridling”. Grounded theory offers the researcher a set of guidelines for building conceptual frameworks that specify the relationships among categories. The guidelines should be used as flexible tools rather than being seen as rigid rules. Grounded theory is a broad method with distinct procedures that work in practice and that are suitable to pragmatic researchers. The “core category” in grounded theory is, as I see it, the constant comparative method. The grounded theory method has been modified by the era within which it exists and by new ideas encountered in the world of inquiry (Annells, 1997). Varying views of what reality is and how it can be known affect the modes of the grounded theory method.

The aim of this study was to generate a substantive theory, based on interviews with women with fibromyalgia, explaining how they manage their main concerns in daily life. The study has an inductive approach in line with classic grounded theory (Glaser, 1992). Twenty-three women living in the southwest region of Sweden were interviewed in-depth about their daily living with fibromyalgia and problems related to this. Probing and follow-up questions were asked by the interviewers when relevant. The interviews were transcribed verbatim and consecutively analysed in line with guidelines for grounded theory. The results showed that the main concern for women with fibromyalgia was to reach a balance in daily life. This concern was resolved by them using different strategies aimed at minimizing the dysfunctional interplay between activity and recovery (core category). This imbalance includes that the women are forcing themselves to live a fast-paced life and thereby tax or exceed their physical and psychological abilities and limits. Generally, the fibromyalgia symptoms vary and are most often unpredictable to the women. Pain and fatigue are the most prominent symptoms. However, pain-free periods occur, often related to intense engagement in some activity, relaxation or joy, but mainly the "pain gaps" are unpredictable. To reach a balance in daily life and manage the dysfunctional interplay between activity and recovery the women use several strategies. They are avoiding unnecessary stress, utilizing good days, paying the price for allowing oneself too much activity, planning activities in advance, distracting oneself from the pain, engaging in alleviating physical activities, and ignoring pain sensations. Distracting from the pain seems to be an especially helpful strategy as it may lead to "pain gaps". This strategy, meaning to divert attention from the pain, is possible to learn, or improve, in health promoting courses based on principles of cognitive behavioural therapy (CBT). We suggest that such courses are offered in primary care for patients with fibromyalgia or other types of longstanding pain. The courses should be led by registered nurses or psychologists, who are experienced in CBT and have extensive knowledge about theories on longstanding pain, stress and coping. Such courses would increase well-being and quality of life in women suffering from fibromyalgia. © 2011 L. R.-M. Hallberg & S. Bergman.

The aim of the study was to explore the perceived health consequences of workplace bullying. Open interviews were conducted with 22 informants; 20 bully victims and two persons working with bullying prevention. Data was assessed and analysed simultaneously in line with grounded theory methodology. A conceptual model was grounded in data, describing experiences of deteriorating psychological and physical health following bullying and efforts of returning to a “normal” life. The core category, “remaining marked for life”, illuminates the manner in which bullying was perceived as a psychic trauma or a traumatic life event causing the bullied person to be marked forever. The model includes five additional categories: “feeling guilt, shame and diminishing self-esteem”, “developing symptoms and reactions”, “getting limited space of action”, “working through the course of events” and “trying to obtain redress”. Bullying included the spreading of rumours and repeated insults aimed at changing the image of the victim and resulting in feelings of guilt, shame and diminishing self-esteem. Physical and psychosomatic symptoms gradually emerge and medical treatment and sick listing follow. The longer the bullying continues, the more limited the possibility to change the situation and the victim has a more limited space of action. Returning to a “normal” life was possible, but presupposed that the victim had worked through of the course of events. The bullied person also tried to obtain redress, such as through monetary compensation or professional confirmation. Despite this, bullying left an internal scar: the bully victim was marked for life.

The aim of this study was to explore what dentition and oral health mean to adult dental care patients' well-being. Qualitative, taped interviews were conducted with 15 participants (over 20 years of age), who were patients at private and public dental health care units in the western part of Sweden. The constant comparative method of grounded theory was used. The interviews were consecutively analyzed in hierarchical coding processes until saturation was achieved. A conceptual model was generated illuminating the meaning of dentition and oral health for the participant's well-being. The core category of the model, struggling to optimize one's self-esteem, was related to four categories, which further described the psychosocial process of increasing one's self-esteem and contributing to well-being. These categories were labelled investing in oneself, being attractive to others, being able to socialize and showing ones social belonging. People who are satisfied with their teeth in terms of function and appearance seem to have developed an optimized self-esteem, which contributes to the well-being in individuals. Consequently, inequalities in oral health according to social belonging may lead to inequalities in self-esteem and well-being.

Living with a child with a disability is often perceived as a permanent stressor to the family and it affects all aspects of family life including the well-being of family members. Since little is known about parenting teenage daughters diagnosed with ADHD, the aim of the study was to gain a deeper understanding of the main problem involved using a grounded theory approach. Interviews were carried out with 12 parents, 11 mothers and 1 father, of teenage daughters diagnosed with ADHD. The parents' situation was conceptualized as living at the edge of one's capability with the properties having the sole parental responsibility, fighting for professional support, being on duty around the clock and trying to solve family conflicts. Parents described how their health was negatively affected by their life situation.

PURPOSE: The aim of this study is to, in the Swedish media debate, explore the discursive constructions of challenges in human rights and freedoms following the national spatial strategy for health and survival during the COVID-19 pandemic.

METHODS: The study, inspired by a critical discourse analytic approach, focused particularly on the issues addressed, subject positions, relations and rhetoric. Seventeen opinion articles published in Swedish national newspapers December 2019 - February 2022 were analysed.

RESULTS: The main contents were threats to democracy, threats to the freedom and rights of specific groups, and threats to the debate itself. Contents were expressed through three discourse dichotomies: contribution vs interjection, documented vs alarmistic, and active on the stage vs commenting from the balcony.

CONCLUSIONS: Striking about the results is the absence of dialogue, the one-way communication, and the absent politicians. It seems that the analysed debate on the challenges of the Swedish COVID-19 pandemic strategy, based on its impact on overall freedoms and rights, has not been the focus of decision-makers during the pandemic. They have neither addressed the threats highlighted in the articles, nor contributed to the discourse. This is worrying for the long-term maintenance and development of a healthy democracy. © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

Purpose: The aim of this study was to investigate people’s experiences of living with dysphagia after stroke, and their experiences of dysphagia management.

Methods: The study design was qualitative, and an open-ended approach to data collection was used, with follow-up probing questions to gain more information as needed. Personal interviews were conducted with five persons who had persisting moderate to severe dysphagia after stroke, living in the south-west part of Sweden. The data were analysed with qualitative content analysis.

Results: When analysing the data, the following theme emerged; “Dysphagia impacts life situations negatively and requires individually adapted, long term support from skilled health care professionals”. The theme consists of three categories: “Learning to manage dysphagia and its complications”, “Professional support with dysphagia varies” and “Finding small moments of joy despite large restrictions in life situations”.

Conclusions: Findings indicated that people with dysphagia experienced a lack of support from health care professionals. Better health care support following discharge from hospital is required to ensure an optimal quality of life. Actions to achieve this may include developing national guidelines for adequate dysphagia follow-up and establishing multidisciplinary dysphagia teams in hospitals and long-term care facilities.

Aim: This study aims at exploring the main concern for elderly individuals with somatic health problems and what they do to manage this.

Method: In total, 14 individuals (mean-74.2 years; range-68-86 years) of both gender including hospitalized and outpatient persons participated in the study. Open interviews were conducted and analyzed according to grounded theory, an inductive theory-generating method.

Results: The main concern for the elderly individuals with somatic health problems was identified as their striving to maintain control and balance in life. The analysis ended up in a substantive theory explaining how elderly individuals with somatic disease were calibrating and adjusting their expectations in life in order to adapt to their reduced energy level, health problems, and aging. By adjusting the expectations to their actual abilities, the elderly can maintain a sense of that they still have the control over their lives and create stability. The ongoing adjustment process is facilitated by different strategies and result despite lower expectations in subjective well-being. The facilitating strategies are utilizing the network of important others, enjoying cultural heritage, being occupied with interests, having a mission to fulfill, improving the situation by limiting boundaries and, finally, creating meaning in everyday life.

Conclusion: The main concern of the elderly with somatic health problems was to maintain control and balance in life. The emerging theory explains how elderly people with somatic health problems calibrate their expectations of life in order to adjust to reduced energy, health problems, and aging. This process is facilitated by different strategies and result despite lower expectation in subjective well-being. © 2011 A.-S. Helvik et al.

Purpose: This is a study on a sport-based intervention, with a focus on physical activity, social relations, and learning, to promote health and well-being in the workplace lived space. Lived space is situated and associated with social and cultural conventions which affect the quality of the perceived space at work. The aim of the paper is to elucidate the participant’s experiences of the intervention and how health and well-being were affected.

Methods: The intervention was conducted with employees from the warehouse of a company within the retail sector. The design consisted of one initial workshop as a baseline, a sport-based intervention, three group interviews, and a final workshop. A hermeneutic phenomenological analysis focused on experiences of the intervention and the meaning of the workplace as the lived space.

Results: Three themes emerged in the analysis; Expressing positive individual effects, Expressing improved work environment and The meaning of the workplace as lived space. The themes are discussed in relation to three basic health foci: physical activity, social relations and learning.

Conclusion: The workplace as a lived space offers a valuable opportunity for sport-based interventions that improve health and well-being through physical activity, social relations, and learning.

Purpose

The most common treatment for resident’s health problems is pharmacological. Little research has been done on how an intervention with a non-pharmacological method, such as a weighted blanket, Through the nursing staff view, we can learn how weighted blankets influence resident’s health in nursing homes. The aim of this study was to explore nursing staff’s experiences of how an intervention with weighted blankets influenced resident’s expressions of health.

Methods

The study had a descriptive qualitative design with semi-structured interviews with 20 nursing staff working in nursing homes, and an inductive content analysis was applied.

Results

The nursing staff expressed that the weighted blanket positively influenced resident’s health in the areas of sleep, physical activity, and psychological behaviour. The weighted blanket made them fall asleep faster, sleep was uninterrupted andthey felt more rested in the morning. The nursing staff observed an increased level of activity as the resident became more energetic . The nursing staff also experienced reduced negative psychological behaviours like anxiety and worrying.

Conclusion

This study indicated that the weighted blanket changed the health expression of resident in several crucial areas. Deep pressure treatment indicates an alternative health-improved treatment for resident in nursing homes. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Purpose:

This study aimed to describe adolescents’ experiences of participating in a health-promoting school-based intervention regarding food and physical activity, with a focus on empowering aspects. 

Method:

The school was located in a urban disadvantaged community in Sweden, characterized by poorer self-reported health and lower life expectancy than the municipality average. Focus group interviews with adolescents (29 girls, 20 boys, 14–15 years) and their teachers (n = 4) were conducted two years after intervention. Data were categorized using qualitative content analysis. 

Results: 

A theme was generated, intersecting with all the categories: Gaining control over one’s health: deciding, trying, and practicing together, in new ways, using reflective tools. The adolescents appreciated influencing the components of the intervention and collaborating with peers in active learning activities such as practicing sports and preparing meals. They also reported acquiring new health information, that trying new activities was inspiring, and the use of pedometers and photo-food diaries helped them reflect on their health behaviours. The adolescents’ experiences were also echoed by their teachers. 

Conclusions: 

To facilitate empowerment and stimulate learning, health-promotion interventions targeting adolescents could enable active learning activities in groups, by using visualizing tools to facilitate self-reflection, and allowing adolescents to influence intervention activities.

Purpose: Being of working age while at the same time needing to help a partner with young onset dementia has specific consequences for spouses. Research to date has been sparse concerning this particular group of spouses. The aim of the study was to explore spouses’ everyday experiences when living with a person with young onset dementia. Method: The study had a descriptive qualitative design with semi-structured interviews with nine spouses. The interviews were analysed using content analysis. Result: The interviewed spouses experienced emotions that varied from feelings of loneliness, frustration, and worry to peace of mind. They said that they used coping strategies, which included adopting a positive mindset, adapting to inabilities, adopting an avoidant approach, and finding ways to recharge. Spouses also felt that they could use more support, both formal and informal. Conclusion: The spouse of a person with young onset dementia has a range of emotional experiences and has resourceful ways of handling everyday life. Various types of support are offered to spouses, however, they seemed to desire more from health care services. © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Bratman first proposed orthorexia nervosa in the late 1990s, defining it an obsession with eating healthy food to achieve, for instance, improved health. Today, in the Swedish media, excessive exercising plays a central role in relation to orthorexia. A few review articles on orthorexia have been conducted; however, these have not focused on aspects of food and eating, sport, exercise, or a societal perspective. The overall aim of this study was to provide an overview and synthesis of what philosophies of science approaches form the current academic framework of orthorexia. Key questions were: What aspects of food and eating are related to orthorexia? What role do exercise and sports play in relation to orthorexia? In what ways are orthorexia contextualized? Consequently, the concept of healthism was used to discuss and contextualize orthorexia. The method used was an integrative literature review; the material covered 19 empirical and theoretical articles published in peer-reviewed journals. This review demonstrates a multifaceted nature of orthorexia research; this field has been examined from four different philosophies of science approaches (i.e., empirical-atomistic, empirical-atomistic with elements of empirical-holistic, empirical-holistic, and rational-holistic) on individual, social, and societal levels. The majority of the articles followed an empirical-atomistic approach that focused on orthorexia as an individual issue, which was discussed using healthism. Our analysis indicates a need for (a) more empirical-holistic research that applies interpretive qualitative methods and uses a social perspective of health, e.g., healthism and (b) examining the role of sports and exercise in relation to orthorexia that takes the problematizing of “orthorexic behaviours” within the sports context into account.

Orthorexia nervosa (ON) describes a pathological obsession with healthy eating to avoid ill health. In the Swedish context, ON is also understood in terms of unhealthy exercise. Fitness gyms are popular health-promoting places, but exercise-related problems, disordered eating and ON-like behaviour are increasing. Personal trainers (PTs) play an important role in detecting unhealthy behaviours. The aim of the present study was to illuminate PTs’ understandings of healthy and unhealthy exercise and eating behaviours in relation to orthorexia nervosa in a fitness gym context. Five focus groups with 14 PTs were conducted. These were analysed using interpretative qualitative content analysis and Becker’s model “Kinds of Deviance.” In contrast to PTs’ health norms (practicing balanced behaviours and contributing to well-being), ON was expressed mainly in terms of exercise behaviour and as being excessive and in total control. The PTs maintain that extreme behaviours are legitimized by an aggressive exercise trend in society and that they fear to falsely accuse clients of being pathological. Certain sport contexts (bodybuilding, fitness competitions and elite sports) and specific groups (fitness professionals) contribute to complicating PTs’ negotiations due to a competition, performance and/or profession norm, making it difficult to determine whether or not to intervene. © 2017 The Author(s)

Purpose: This study aimed to describe and problematize the advice on exercise and diet that personal trainers (PTs) provide to their clients from a gender perspective. Method: The present study had an explorative design, and the interviews were analysed using an interpretative qualitative approach. Seven focus group discussions were conducted with 19 PTs (aged 23–47 years). Results: The findings indicated that the PTs had a gender-neutral health advice approach to both women and men, guiding them towards a relaxed attitude to exercise and diet, prioritizing and rationalizing their exercise and diet and eating a natural diet. PTs also had a gendered health advice approach as regards women who showed unhealthy exercise and eating behaviours; advising them to eat more and exercise less, to focus on performance rather than appearance and to avoid heavy weightlifting. Some PTs acted evasively and did not give advice to men. Conclusions: Both approaches include advice that reflect health as control and health as release. From a gender perspective, PTs health advice both challenged and reproduced the stereotypical male norm in the fitness gym space. However, PTs gendered health advice may create different opportunities for men and women to promote their health and well-being in the fitness gym. © 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

This article describes a novel approach to giving dietary advice, which is called "Dietary Advice on Prescription" (DAP; Matordning på Recept [MoR] in Swedish). It is the same principle as prescription on medicine and "Physical Activity on Prescription" (PAP; Fysisk aktivitet på Recept [FaR] in Swedish). The main idea is that a written prescription will strengthen the oral advice and emphasize certain aspects of the dietary recommendation. The DAP is on the brink of being tested in a planned study.

The living conditions of young adults in Sweden have changed during the last decades due to the economic and employment situation in society. Although oral health is mainly considered to be good in this age group, their use of dental care has decreased and their priorities and opportunities regarding oral health are little known. The purpose of this study was to describe the views of Swedish young adults on their oral health and oral health-related quality of life (OHRQoL). The design of the study was qualitative, using content analysis. Sixteen young adults, aged 21-29 years, were interviewed. The findings from the interviews were summarized under the theme "Young adults reflected on their OHRQoL in a time perspective" consisting of three categories: "Past experiences, Present situation, and Future prospects." The OHRQoL of young adults is dependent not only on their own experiences of oral health during childhood and their received dental care but also on their present self-perceived oral health, oral health habits, and social life; together with their expectations of future oral health. The findings in this study indicate that the oral health awareness and needs of young adults, as well as their expectations of oral care, merit further follow-up. © 2015 G. Johansson & A.-L. Östberg.

Halmstad University’s profile as the University of Innovation consists of the strong area of Health and Lifestyle. As many European societies are characterized by societal challenges, this strong area will turn out to be an area of research that has strong future relevance. Challenges related to an aging population, increased mental illness among young people, marginalization of disabled people, and the issues related to working life and health will be monitored by researchers within work and welfare with the help of qualitative studies.

This study aimed to illuminate factors that undermine the healthy habits of adolescents from a multicultural community with low socioeconomic status (S.E.S.) in Sweden with regard to physical activity (P.A.) and food, as stated in their own voices. Adolescents (n = 53, 12–13 y/o) were recruited from one school situated in a multicultural community characterized by low S. E.S. Embracing an interpretive approach, 10 focus-group interviews were conducted to produce data for the study. The focus-group interviews were audio recorded, transcribed verbatim, and analysed using qualitative content analysis. The analysis resulted in two major themes: (1) the availability of temptations is large, and support from the surroundings is limited; and (2) norms and demands set the agenda. The adolescents’ voices illuminate a profound awareness and the magnitude of tempting screen-based activities as undermining their P.A. and healthy food habits. Moreover, several gender boundaries were highlighted as undermining girls’ P.A. and healthy food habits. The adolescents’ stories illuminated that it is difficult for them, within their environment, to establish healthy habits with regard to P.A. and food. To facilitate the adolescents’ healthy habits, we suggest that support from family, friends, the school, and society at large is essential.

As a guest editor of the special edition of the International Journal of Qualitative Studies on Health and Well-being I would like to present seven designated articles. The current thematic cluster represents qualitative research illustrating the challenges in supporting the central aspects of health and wellbeing for individuals in various situations linked to human vulnerability. This theme cluster will provide the reader with a new and greater understanding of the inner meaning of vulnerability and greater insights into how health and well-being, achieved through different forms of support and care, can enhance empowerment in spite of obstacles such as illness, disease, impairment, old or young age, or gender. Different kinds of qualitative methodologies have been used to elucidate the phenomenon of vulnerability. Data collection procedures vary from qualitative interviews and diaries to focus group interviews. Qualitative content analysis, phenomenographical approach, and grounded theory are used to analyse the data in the different studies. The common denominator for the included articles is the commitment of the authors to impart knowledge in terms of greater understanding of the core aspects of health and well-being among humans in different vulnerable situations. © 2016 H. Jormfeldt.

As a Guest Editor of the International Journal of Qualitative Studies on Health and Well-being’s special edition on perspectives on health and well-being in nursing, it is my wish to present four original articles embracing some essential core aspects of nursing science irrespective of their specialization. They represent different aspects of qualitative research that focus on; the challenge of integrating core concepts of health into mental health nursing praxis, the experiences in psychiatric rehabilitation from the perspective of both patients and their relatives, and the nurses’ experiences of giving support to patients during the transition to hospital-bound hemodialysis. The common basis for the articles is the authors’ ambition to generate nursing knowledge in terms of core elements for the provision of health and well-being among individuals with a need for nursing care.

This paper will explore two contrasting paradigms in mental health care and their relationship to evidence-based practice. The biomedical perspective of pathogenesis and the health perspective of salotogenesis are two major diverse views in mental health care. Positive dimensions of health are traditionally viewed as software not suitable for statistical analysis, while absence of symptoms of disease are regarded as measurable and suitable for statistical analysis and appropriate as a foundation of evidence-based practice. If the main goal of mental health care is to enhance subjectively experienced health among patients, it will not be sufficient to evaluate absence of symptoms of disease as a measure of quality of care. The discussion focuses on the paradox of evidence-based absence of illness and disease versus subjectively experienced health and well-being as criterions of quality of care in mental health care.

Purpose: This discussion paper aims to explore the need of a clarified definition of master’s level mental health nursing competencies in terms of knowledge, skills and attitudes in a European context. Mental health service users have, in spite of their right to equal overall health, higher rates of physical illness and are more likely to experience premature death than the general population. Implementation of a holistic concept of health comprising mental, physical and social aspects of health in mental health services has previously proved to be challenging. Methods: Master’s level mental health nursing competencies in recent literature are discussed and illuminated in terms of knowledge, skills and attitudes in order to enable the promotion of equal overall health among service users in mental health services. Results: The discussion show contents, values and utility of master’s level mental health nursing competencies in mental health services and contribute to reduced role ambiguity by distinguishing master’s level responsibilities from undergraduate nursing tasks and obligations of other professionals in mental health care. Conclusion: This discussion paper shapes implications for developments in master’s level mental health nursing education curricula. © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Background: The mental health-care system in Sweden, as in many other counties, has its main focus on the reduction of psychiatric symptoms and the prevention of relapses. People diagnosed with schizophrenia often have significant health issues and experience reduced well-being in everyday life. The social imaginary of mental illness as an imbalance of the brain has implications concerning general attitudes in society. The news media are an important source of information on psychiatric disorders and have an important role in cultivating public perceptions and stigma. News media can contribute to the mental illness stigma and place individuals with mental illnesses at risk of not receiving adequate care and support.

The aim of this preliminary study was to describe users’ experiences of housing support in everyday life.

Results: The results revealed three themes of housing support, which were needed, but frequently insufficiently fulfilled in the municipality. The three themes were: ‘‘Support to Practice Healthy Routines in Daily Life,’’ ‘‘Support to Shape Meaningful Contents in Everyday Life,’’ and ‘‘Support to Meet Needs of Integrity and Respect.’’

Conclusions: The findings support previous studies arguing that current health care and housing support fails to meet basic needs and may lead to significant and unnecessary health risks. Further investigation is needed regarding the links between attitudes to mental illness in society and political and financial principles for health care and housing support for persons with schizophrenia. Further research is needed regarding the role of the media in policymaking concerning health promotion interventions for people diagnosed with schizophrenia. © 2016 H. Jormfeldt & M. Hallén.

The Boston Psychiatric Rehabilitation Approach (PR) has been described as neither being a particular technique nor a single intervention but a service model within the mental health system aiming to promote recovery and the achievement of a meaningful life, rather than simply supporting adaptation or survival in the community. A qualitative approach was used to describe clients’ experiences of a BR implementation project in a county in Sweden. The findings from the interviews could be summarized in the theme “The process of rehabilitation” consisting of three categories: Structure, Participation and Relationship. The results suggest that clients do not often realize nor are able to verbalize their goals before they have been given the possibility to reflect their thoughts in collaboration with a trusted person. It is thus important that PR schedules its special structure to secure client participation by giving the clients opportunity to get their thoughts reflected to be able to participate in decision making regarding their own care. © 2014 H. Jormfeldt et al.