The aim of this thesis is to investigate the self-proclaimed performance of the National Board of Institutional Care, and its specific youth care homes in Sweden (SiS), concerning SiS work with institutionalised children and youth in relation to law of The Care of Young Persons Act (LVU). Special focus is also given to how the SiS self-assessment contrasts with the accounts given by institutionalised youths. We have investigated SiS claims present on their website since it provides ample documentation, information and deeds, and investigated reports by youth in the media, research and news outlets. We have elected to code all collected data and have thus identified key recurring themes present in youth and SiS reports.We have then regarded these findings with respect to our theories that are presented in the results and analysis section along with previous research. In this section we maintain that the description provided by youths at SiS is problematic and often shows a lack of care giving instances or staff that master the tools required to meet the youth in a constructive manner. In the discussion we once again maintain our theories and methodological approach that is based on Discourse analytical grounds that maintain the importance of language and the messages signified through actions.

Introduction: The study provides a comprehensive overview of how it has become increasingly common in today's job market for employers to request criminal record checks during the hiring process. Purpose: The purpose of this study was to examine how the criminal record affects the employment prospects of individuals with a criminal background and to analyze the methods identified as effective in supporting individuals who have been denied employment due to their criminal record. Method: To address the study's objectives, a qualitative research approach was chosen, involving content analysis and document analysis. Results: Individuals with a criminal record face greater challenges in reintegrating into the labor market due to the stigmatization and labeling associated with having a criminal record. The results showed that individuals with a criminal record experience social exclusion, discrimination, and stigmatization. Furthermore, the findings indicate that these individuals are indirectly punished even after serving their sentence, as they face limitations in their opportunities for labor market reintegration. Society views them as deviant, further hindering the reintegration of individuals with previous criminal convictions and increasing the likelihood of recidivism. Therefore, it is important to implement strategies and interventions that focus on the rehabilitation and reintegration of individuals with criminal backgrounds into the labor market.

The Swedish education Act is one of several laws and legal documents regulating every children's right to an equal education and where every child's differences are an asset, integrating children's differences instead of separating them. Despite this, previous research shows that the swedish school system is failing in including necessary means for children with special needs and also discusses what the necessary means are for a successful schooling. In light of this, the aim of this study is twofold where I first aim to show the lack of including necessary support for children with special needs in the Swedish school education. By pointing this out, I will move on to the main purpose of the study which is to examine how Swedish teachers within the municipality of Malmö work in order to include these children in the education. The method used for answering the purpose and research questions of the study are semi structured interviews focusing on the concept of inclusion and including children with special needs in the normal education system. The developed concept on inclusion as well as learning and development stems from the theoretical framework, where I have also identified specific themes that will be applied to collect relevant findings from the interviews. The result of the study shows that, as previous studies show, that there are failing points in the lack of resources when trying to include students with special needs. But, the teachers reflect in many ways when working with inclusion of students in need of special support.

Socialsekreterare inom ekonomiskt bistånd stöter på risker i sitt arbete som innebär att de tenderar att utsättas för arbetsrelaterat klientvåld mer än andra yrkesgrupper. Syftet har varit att studera upplevelserna av arbetsrelaterat klientvåld bland socialsekreterare som arbetar med ekonomiskt bistånd,hur de har hanterat upplevelserna och hur de har blivit påverkade av dessa. Studien analyserar dimensionen av den geografiska närheten till sina klienter parallellt med arbetsrelaterat klientvåld. Åtta kvalitativa semistrukturerade intervjuer har genomförts med socialsekreterare som arbetar med ekonomiskt bistånd i mindre kommuner. Empirin har analyserats utifrån organisationsteori med inriktning på klientrelationen och organisationskultur samt teori om copingstrategier. Upplevelserna av arbetsrelaterat klientvåld presenteras i termer av våld, hot och trakasserier. Resultatet presenterar att våld är tämligen ovanligt förekommande bland socialsekreterarna, medan hot och trakasserier tenderade att vara vanligt förekommande. Studien fann 16 olika copingstrategier som användes för att hantera upplevelserna av arbetsrelaterat klientvåld. Copingstrategierna delades in i problemfokuserade och emotionsfokuserade. Upplevelsen av arbetsrelaterat klientvåld påverkade socialsekreteraren genom att de ändrade sitt arbetssätt och blev avvaktande i sin yrkesroll. Privatlivet påverkades genom att socialsekreteraren undvek lokala platser för att inte träffa på klienten, fick med sig upplevelserna hem där obehaget överfördes till deras familjer. Resultatet fann att den geografiska närheten till sina klienter i relation till arbetsrelaterat klientvåld gör att upplevelserna av arbetsrelaterat klientvåld förstärks. Arbetsrelaterat klientvåld är normaliserat inom organisationen. Organisationen saknar tydliga gränser för vad som klassificeras som arbetsrelaterat klientvåld. Det resulterar i att socialsekreterare inte rapporterar klientvåld som de anser är icke acceptabelt.

Introduction: Although research has shown that evidence-based family interventions in research settings improve the communication and understanding of parental mental illness, there is a lack of knowledge about interventions in an everyday clinical context. Aim: This study explores how families with parental mental illness experience family interventions in a natural clinical context in psychiatric services. Method: Five families with children aged 10–12 were recruited from psychiatric services in southern Sweden and interviewed in a manner inspired by naturalistic inquiry and content analysis. Both family and individual interviews were performed. Results: In striving to lead an ordinary life while coping with the parental mental illness, these families sought the support of the psychiatric services, especially in order to inform their children about the mental illness. Despite different family interventions, the family members felt supported and reported that the number of conflicts in the family had decreased. The parents were appreciative of help with child-rearing questions, and the children experienced a calmer family atmosphere. However, the partner of the person with mental illness experienced being left without support. Implications for practice: Our study shows that psychiatric services, and especially mental health nurses, are in a position to more regularly offer family interventions in supporting the children and the healthy partners.

Background: A parental mental illness affects all family members and should warrant a need for support.Aim: To investigate the extent to which psychiatric patients with underage children are the recipients of child-focused interventions and involved in interagency collaboration.Methods: Data were retrieved from a psychiatric services medical record database consisting of data regarding 29,972 individuals in southern Sweden and indicating the patients' main diagnoses, comorbidity, children below the age of 18, and child-focused interventions.Results: Among the patients surveyed, 12.9% had registered underage children. One-fourth of the patients received child-focused interventions from adult psychiatry, and out of these 30.7% were involved in interagency collaboration as compared to 7.7% without child-focused interventions. Overall, collaboration with child and adolescent psychiatric services was low for all main diagnoses. If a patient received child-focused interventions from psychiatric services, the likelihood of being involved in interagency collaboration was five times greater as compared to patients receiving no child-focused intervention when controlled for gender, main diagnosis, and inpatient care.Conclusions: Psychiatric services play a significant role in identifying the need for and initiating child-focused interventions in families with a parental mental illness, and need to develop and support strategies to enhance interagency collaboration with other welfare services.

This book offers insights on politics and ethics of representation that are relevant to researchers concerned with struggles for justice. It takes moments of discomfort in the qualitative research process as important sites of knowledge for exploring representational practices in critical research.

The Politics and Ethics of Representation in Qualitative Research draws on experiences from research processes in nine PhD projects. In some chapters, ethical and political dilemmas related to representational practices are analyzed as experienced in fieldwork. In others, the focus is on the production of representation at the stage of writing. The book deals with questions such as: What does it mean to write about the lives of others? How are ethics and politics of representation intertwined, and how are they distinct? How are politics of representation linked to a practice of solidarity in research? What are the im/possibilities of hope and care in research?

Drawing on grounded empirical research, the book offers input to students, PhDs, researchers, practitioners, activists and others dealing with methodological dilemmas from a critical perspective. Instead of ignoring discomforts, or describing them as solved, we stay with them, showing how such a reflective process provides new, ongoing insights.

AIMS: To describe and compare perceptions of collaboration between care providers on the part of three groups of Registered Nurses working in municipal care and having particular responsibility concerning the care of frail older people with intellectual disability (ID); and, furthermore, to investigate the presence of and compliance with guidelines for the coordination of care.

DESIGN: National survey study with cross-sectional design.

METHODS: Nurses (N = 110) with key positions concerning people with ID answered a national questionnaire about collaboration, guidelines and coordinated individual plans. Descriptive and comparative statistical analyses were applied.

RESULTS: The meetings on cooperation and coordination of interventions were attended most frequently by nurses, and least frequently by social workers. The nurses were overall satisfied with the collaboration but perceived shortcomings in the case of inpatient and outpatient psychiatric care. Only in about half of the meetings for making care plans participated the people with intellectual disability and next of kin.

Sjukhuskuratorer samtalar med patienter på vårdsalar där möjlighet till avskildhet

eller lugn ibland är liten. Denna uppsats har som ambition att undersöka vilka

metoder för att skapa relation och en hållande miljö som sjukhuskuratorn

använder sig av i sådana situationer, för att öka förståelsen för hur arbetet går till i

praktiken.

Denna kvalitativa intervjustudie visar att det finns ett flertal metoder som är

användbara för att visa närvaro och skapa relationer tillpatienter i vårdmiljö –

både fysiska och verbala. För att skapa en hållande miljö använder kuratorerna

metoder för att stänga ute störningsmoment och upprätthålla tydliga ramar i

samtalen. Metoderna används ofta i kombination med varandra och anpassas efter

situationen. Studien visar också att de fyra intervjuade kuratorerna är

samstämmiga i mycket trots att de ofta jobbar ensamma, samt att de lärt sig

metoderna genom utbildning och genom att iaktta andra kuratorer.

Utifrån medias inflytande över samhället syftar studien till att undersöka hur socialsekreterare upplever att deras arbete med barn- och ungdomsutredningar påverkas av hur media framställer socialtjänsten och det sociala arbetet men även hur media påverkar socialsekreterare som profession. Media kan genom sin rapportering och granskning av socialtjänsten nå ut, väcka, intresse och bilda åsikter hos allmänheten. Socialsekreterare som arbetar med barn- och ungdomsutredningar väcker i sin tur starka känslor genom sin yrkesroll och sina beslut. Tidigare forskning visar att socialsekreterare nationellt och internationellt delar bilden av att medias framställning av socialtjänsten och dess arbete i negativ bemärkelse påverkar det sociala arbetet och professionen i olika utsträckningar. Vi har i denna studie valt att använda oss utav vetenskapligt granskade artiklar från Australien, England, Nya Zeeland, USA och Sverige. Studiens genomförande bestod av fem semistrukturerade intervjuer med socialsekreterare yrkesverksamma i Malmö, vilket tillsammans med våra teorier; dagordningsteorin, organisationsteorin och professionsteorin utgör grunden för vår analys och vårt resultat. Resultatet i studien visar att socialsekreterare som vi intervjuat upplever en gemensam bild av att medias rapportering gällande socialtjänsten och dess arbete med barn-och ungdomsutredningar övervägande negativ men menade på att den negativa rapporteringen leder till att socialtjänstens arbete granskas vilket är en fördel så att arbetet förblir rättssäkert. Vidare delar våra intervjudeltagare bilden av att ett bra samarbete med media hade kunnat leda till en positiv bild av socialtjänsten men även professionen.  

Denna text innehåller tre exempel på pedagogiskt utvecklingsarbete som jag som universitetslärare har erfarenhet av. Exemplen rör konstruktiv länkning, samverkan och co-teaching samt forskningsanknytning och en god lärandemiljö. Dessa exempel diskuteras utifrån pedagogiska resonemang och värderas kritiskt – vad har jag lärt mig i relation till läraruppdraget? 

Läkemedelshantering har blivit en betydande del av äldreomsorgen. Medicinskt utbildad personal såsom sjuksköterskor delegerar sina uppgifter till omsorgspersonalen som ofta saknar medicinsk kunskap. Syftet med denna artikel är att utforska hanteringen av läkemedel påsärskilda boenden för äldre personer. Fokus ligger på huromsorgspersonalen och de äldre interagerar i relation till medicinerna och rutinerna kring dessa. Deltagande observationer gjordes på sju boenden, och det empiriska materialet analyserades genom teorier om ‘local routine culture’ och materialitet. Resultaten visar hur de äldre kanförsöka göra motstånd eller förhandla om läkemedlen och dess rutiner genom till exempel uttrycka sin motvilja i ord eller handling, ställa frågor eller be om mer medicin. Medan rutiner formar en institutionellordning och ger personalen makt, kan motstånd och förhandlingar till viss del stärka de äldres självkänsla och inflytande. Medicinerna påverkar förhållandet mellan omsorgspersonal och de äldre genom att möjliggöra interaktion. Att se hanteringen av läkemedel som ett socialt fenomen fördjupar förståelsen för hur det påverkar omsorgsarbetet och illustrerar hur hälso-och sjukvård och social omsorg är nära sammanflätade inom ramen för särskilt boende.

This article explores the views on medical knowledge and its circulation from the perspective of a privileged group – the scientists themselves who are the main actors in producing medical knowledge. The concept of sharing knowledge helps to highlight how knowledge circulation is affected by digitalisation, which changes scientific working conditions and sometimes makes sharing problematic. It reveals the underlying idea of knowledge as an exclusive property and the frictions that occur when this idea is challenged.

Anhörigkonsulenter arbetar med specialiserat stöd till anhöriga inom ramen för kommunernas anhörigstöd. Under covid-19-pandemins inledande fas under våren 2020 stängdes dock stödjande verksamheter till anhöriga i huvudsak ned. I den här artikeln, som bygger på kvalitativa intervjuer med anhörigkonsulenter, undersöks hur anhörigkonsulenter upplever att deras arbete med anhöriga förändrats under pandemin och vilka interaktionella strategier de beskriver. Trontos (1993) omsorgsetik har använts som teoretisk ram. Intervjupersonerna skildrar hur deras möten med anhöriga tagit nya former, främst i form av telefonsamtal och möten utomhus. Kontakterna med anhöriga sker nu framför allt på anhörigkonsulenternas initiativ jämfört med tidigare, och platsens betydelse för mötet har blivit mera påtaglig och något man måste planera. Mötenas innehåll har också förändrats och upplevs som tyngre. Anhörigkonsulenterna framhäver att de snarare kan lyssna och bekräfta än erbjuda praktiska lösningar eftersom dessa är försvårade. Det emotionella stödet till anhöriga har blivit mer framträdande än tidigare, vilket också ställer krav på anhörigkonsulenternas emotionella kompetens. 

Nursing homes are often places where older persons “come to die.” Despite this, death and dying are seldom articulated or talked about. The aim of this study was to explore assistant nurses’ experiences of conversations about death and dying with nursing home residents. This study is part of an implementation project through a knowledge-based educational intervention based on palliative care principles. An ethnographic study design was applied in seven nursing homes, where eight assistant nurses were interviewed and followed in their daily assignments through participant observations. The assistant nurses stated that they had the knowledge and tools to conduct such conversations, even though they lacked the time and felt that emotional strain could be a hinder for conversations about death and dying. The assistant nurses used the strategies of distracting, comforting, and disregarding either when they perceived that residents’ reflections on death and dying were part of their illness and disease or when there was a lack of alignment between the residents’ contemplations and the concept of dying well. They indicated that ambivalence and ambiguity toward conversations about death and dying should be taken into consideration in future implementations of knowledge-based palliative care that take place in nursing homes after this project is finalized.

The connection between neuroscience, popular media and lay perceptions of the brain involves the framing of complex scientific processes and results through familiar cultural narratives and metaphors. Such narratives are often built on the premise that neuroscience, with the help of powerful new technologies, will finally solve the mysteries of brain and mind, consciousness and morality. At the same time, popular culture—especially the science fiction genre—tends to focus on worst case scenarios of the implementation of technology. This article explores cultural narratives of what the brain is and how it functions in two different contexts—among neuroscientists and within popular culture. In particular, narratives about technology and the malleable brain as well as the notion of the mad scientist are studied. The article explores how these narratives are presented and used in popular culture and how neuroscientists relate to the narratives when describing their work. There is a contrast, but also a blurring of boundaries, between actual research carried out and the fictional portrayals of scientists constructing, or altering, fully functional brains. To some extent, the narratives serve as a background for the public’s understanding of, and attitude towards, neuroscience—something that must be taken into consideration when dealing with the therapeutic treatment of patients. The narratives of neuroscience in popular culture are to a certain degree shaped by actual scientific practices and findings, but neuroscience is also influenced by laypeople’s perceptions, which often have their roots in the narratives of popular culture.

This study explores the experiences and reflections of staff in intellectual disability (ID) services concerning ageing with ID. Qualitative interviews were conducted with 24 staff members in group homes and daily activity centres. The findings showed that the staff were uncertain about the signs of ageing in people with intellectual disabilities; they compared the life conditions of these people with conditions in older people without intellectual disabilities. Their emphasis on an active lifestyle was very strong. The staff members also mentioned uncertainty about how to facilitate assistive devices and whether ‘ageing in place’ was the best solution. The overall theme was manifested as ambivalence where notions of older people with intellectual disabilities seemed incompatible with notions of old age in general and could be explained by the theoretical concept of age coding. The findings of this study indicate the need to provide education about ageing to staff working in ID services.

There are many risk factors for youth regarding the development of a criminal behaviour. The purpose of this study is to examine how youth from families with low socio-economic status have a bigger risk of becoming criminals because of their low socio-economical background. The study is mainly focusing on the risk factor; low socio-economics and risk factors that are related to low socio-economics such as housing conditions and school. It’s a literature study that is based on previous research that is going to be interpreted by two different criminological theories. To give the reader an overall picture we are going to examine other risk factors as well. The result of the study shows that low socio-economics is an undeniable risk factor for developing a criminal behavior. It also shows that the residential area and the structural organization in the residential area can have a huge impact on the youth living there. Many times the whole area is a low socio-economic area which previous studies show is a usual risk factor. Meanwhile the structural organization in a residential area can sometimes make a risk factor while in other areas, it can be a protective factor, depending on how the structural organisation looks. The result also shows that children and youth in schools in these low socio-economic areas, present lower grades than the ones in other neighbourhoods. School results play a big role in the development of a criminal behaviour - low results are a big risk factor while good results can be a protective factor. 

The purpose of this qualitative study is to investigate the difficulties that people who have committed criminal acts experience when re-entering into society. The purpose is also to examine what can improve the re-entry and reduce recidivism. We therefore chose to conduct interviews to be able to capture the individuals' experience when reintegrating into society after committing a crime. We interviewed six members from Krami, which is an organization dedicated to help individuals who have committed a crime, or who have come out of an addiction. An individual who has committed criminal acts may encounter obstacles, as well as risk of not being accepted by society, and thus end up in exclusion. Therefore, we chose to base our analysis based on three theories that we considered relevant to the study, these theories are the stamping theory, sense of coherence (SOC) and the stigma theory. We draw attention to the fact that individuals who have a criminal past may experience difficulties in finding a job due to employers requesting criminal records, but also that the jobs are offered as jobs with lower status and lower pay. We have also come to the conclusion that there are difficulties with housing, as many landlords request that you have no payment remarks, which many who have served a sentence have. The results of this study also show that family and friends are a good support for reintegration into society, and in combination with Krami, which is an organization for individuals who have previously committed criminal acts. 

Co-dependency is discussed as a problematic category and its meaning have changed over time and within different contexts. The aim of this study is to take an inside perspective, investigating the lived experience of co-dependency as it is described in Swedish podcasts. The study frames two questions: How the experience of living close to a substance abuser is described in Swedish podcasts and how the co-dependent individuals describe their situation has changed.

The material of the study consists of six episodes of Swedish podcasts focused on addiction and co-dependency. Using methods of qualitative content analysis and thematic analysis the podcasts have been transcribed, coded, and themed according to the framed questions. The identified themes have been analysed from a phenomenological perspective in relation to theories of coping and perceived self-efficacy.

The study identifies six themes which answer the first framed question, as they describe the lived experience of co-dependency: loss of self-focus, searching for approval, need for control, to be in denial and to show a façade. From a phenomenological perspective it is interpreted that co-dependent people direct their intentionality towards the substance abuser. Experiences of denying own needs and protecting an image can be interpreted as a limited lifeworld among co-dependents. The study further identifies a usage of emotional coping strategies during co-dependency. Recovery has been found through problem-solving strategies i.e., to redefine the situation, to search for information and to express feelings.  

To answer the second framed question, how co-dependents describe the experience of changing their situation, themes have been found in finding answers for experienced difficulties and finding support among like-minded. Support given by others are interpreted to have strengthen the perceived self-efficacy by giving opportunity for social learning and positive emotional control.

The legislation should be gender neutral, and should not have a gender bias, but it does happen that the court takes decisions based on gender stereotypes and norms. The purpose of this thesis is to investigate if there are any gender constructions in the Care of Young Persons Ac, to highlight these possible differences between how boys and girls get judged according to article 3 in the law and also on what grounds the girls and boys are taken into custody. The thesis is based on 28 judgements from the Administrative court of appeal in Sweden. The first question that is answered in the thesis is how girls and boys are represented or written about in the judgements regarding article 3 in the Care of Young Persons Act. The second question that is answered is on what grounds these children are taken into compulsory care and if these grounds differ on the basis of gender. Gender theory is the theoretical framework in this thesis and is applied on the judgements. The results in this thesis show that there are certain differences between how boys and girls are judged according to article 3 in the Care of Young Persons Act. The analysis of the 28 judgements show that the differences can be that girls are taken into compulsory care based on descriptions of their sexuality. Their mental illnesses and emotions are more highlighted in the judgements. The results found that there are more boys taken into compulsory care and they are more involved in criminality and have violent behaviour and a heavier drug addiction compared to the girls. The gender differences could mostly be seen in statements made by the social welfare board in the judgements and in some statements made by the Administrative court of appeal when they described the “vagabonding” lifestyle of the girls.

This study aims to show how socialworkers in financial assistance experience that clients react to rejection decitions, how these reactions affect them mentally and how they cope with it. Four semi-structured interviews with socialworkers were conducted to collect material for the study, who have varying work experiences in the field. The theories used for analyses of the material are Resilience and Coping, which have been chosen do to relevance and can enable understanding of the phenomenon. The results of the study show that socialworkers experience that angry clients had bigger effect on their mental health at the beginning of their employment. The socialworkers have, according to the studys results, developed high resilience in work and a numerous of coping-strategies. The most common strategies used were self-controlling, seeking social support and planful problem solving. Previous research has shown that the workenvironment is crucial for socialworkers wellbeing, which the material of the study strenghtens. The studys main result and analysis is an importance of resilience and coping-ability for socialworkers to avoid mental illness.

Syftet med denna c-uppsats är att belysa den diskurs som finns kring ekonomiskt bistånd och individer som erhåller försörjningsstöd i Svenska tidningar. Vidare är det av intresse att undersöka vad diskursen kan få för konsekvenser för individerna i fråga. Metoden som användes för att besvara syftet är kritisk diskursanalys. Efter genomläsning av artiklarna kunde tre teman identifieras och analysen delades därmed upp enligt dessa teman; att Malmö är en generös stad som betalar ut höga bistånd, kopplingar till arbetslöshet och arbetsmarknadsprogram samt slutligen kopplingar till utrikesfödda. Temana analyserades enligt Faircloughs tredimensionella modell. Det som arbetet resulterade i är att bidragstagare stigmatiseras. Diskussionen kring vilka begränsningar och möjligheter bidragstagare har är bristande i svenska nyhetstidningar. Detta eftersom artiklarna använder statistik och rapporter för att snarare rikta kritik mot lokalpolitiken, biståndshandläggare eller individerna som erhåller försörjningsstöd.

The purpose of this study has been to understand and theorize the phenomenon of honor andhonor-systems. Honor-systems has been a widely discussed theme by different outsources.Throughout the last 20 years there has been many cases of murders rooted in the preservationof one’s honor and reputation. To understand the different factors behind honor-system,relevant theories have been carefully selected to fit the theme and direction of this study. Thechoice of method for this paper has been a qualitative literature study where the author hasexamined previous papers, reports, and other relevant studies to get an understanding of thesubject. Then the result was analyzed by two theories, a cultural theory, and a theory ofintersectionality. While researching the subject of honor-system, it has become clear that thefield of honor-systems is a researched field, there are multiple reports on the matter. Insummary the result showed that in honor-systems the biggest victim is often, women as theyare both the victim of violence and control and as the same time perpetrators. In differentcultures there are different expectations on females and males, and in in honor-systems thesystem is run as a patriarchal one. There were some key differences between the two theorieswhen trying to understand honor-systems and especially when trying to understand a culturesimpact on the individual. It has become clear that the systems of honor affect many people insociety.

Förord I januari 2018 träffade branschorganisationen KFO Personlig Assistans en grupp forskare och den tidigare socialministern Bengt Westerberg, för att prata om forskningens betydelse för den personliga assistansen. Vi kunde då konsta- tera att det finns mycket forskning på området, men att forskningen till stora delar är okänd och sällan använd eller refererad. Idén om en antologi med en mer lättillgänglig beskrivning av forskningen tog form. En redaktion utsågs och en referensgrupp med representanter för funktionshinder- och brukarrörelsen tillsattes. Nu, knappt ett år senare, presenterar 21 forskare här sitt material i en antologi som belyser flera olika perspektiv och spänner över de senaste tio årens forskning inom personlig assistans. Antologin kan med fördel användas både som en över- blick över vilken forskning som är gjord och som en källa att ösa ur för den som vill lära. Med stort tack till alla medverkande och ett särskilt tack till redaktionen,

BACKGROUND: While a large body of research has focused on the challenges experienced by healthcare staff when providing sexual and reproductive health services, little attention has been paid to the ways healthcare providers navigate these challenges. This study examined healthcare providers' accounts of encounters when providing sexual and reproductive health (SRH) services to migrants in Southern Sweden. It sought to examine challenges and dilemmas experienced by healthcare providers, strategies used to navigate these challenges and dilemmas, and assumptions underlying participants' accounts.

METHODS: The data collection was conducted between September 2020 and March 2021. Qualitative thematic analysis was used to analyze thirty-one interviews with healthcare providers working in youth clinics and women healthcare clinics. The analysis was guided by a conceptual framework combining person-centered care approach, Foucault's concepts on power/knowledge, and theories to navigate diversity in healthcare setting: cultural competency and cultural humility.

RESULTS: Three themes were identified in the analysis: 1) Between person centeredness and cultural considerations; 2) Knowledge positions and patient involvement; and 3) beyond the dyadic interaction healthcare provider-patient. Some participants understood person-centered care as individualized care where the influence of culture on the encounter should be de-emphasized, whereas others tended to highlight this influence. Many participants viewed the influence of culture as primarily driven by migrants' cultural backgrounds, and as a source of challenges and dilemmas. Participants' strategies to navigate these perceived challenges and dilemmas included practicing cultural humility and seeking cultural competency. Knowledge positions also emerged as an important aspect of participants' accounts of encounters with migrants. Many participants experienced that migrant patients were lacking knowledge about the body and sexuality. This disadvantaged knowledge position affected migrant involvement in care. Additionally, the study shows how participants placed their experiences in a broader organizational and social context. Participants highlighted several organizational challenges to encountering migrants and discussed dilemmas stemming from the interplay between migrants' structural and individual disadvantages.

CONCLUSIONS: The study findings illuminate the complex links between person-centered care and two important dimensions of the encounters with migrants: culture and knowledge positions. They also shed the light on the organizational and structural challenges surrounding these encounters. These findings suggest that multilevel strategies are needed to improve the quality of encounters when providing SRH services to migrants. These strategies could include ensuring universal access to SRH services to migrants, adjusting the encounter duration when interpretation is needed, and providing necessary resources to healthcare providers to build their structural competency.

Background

Previous research has shown that migrants in Sweden are disadvantaged in terms of sexual and reproductive health and rights (SRHR). SRHR policies might play a crucial role in shaping migrants’ SRHR outcomes. The purpose of the study was to critically examine: a) how migrants were represented in the discourses embedded within Swedish SRHR-related policies, and b) how migrants’ SRHR-related issues were framed and addressed within these discourses.

Methods

Critical discourse analysis (CDA) was used to analyze a total of 54 policy documents. Following Jäger’s approach to CDA, discourse strands and entanglements between different discourse strands were examined.

Results

Our findings consisted of three discourse strands: 1) “Emphasizing vulnerability”, 2) “Constructing otherness”, and 3) “Prioritizing the structural level or the individual level?”.

Migrants’ representation in Swedish SRHR-related policies is often associated with the concept of vulnerability, a concept that can hold negative connotations such as reinforcing social control, stigma, and disempowerment. Alongside the discourse of vulnerability, the discourse of otherness appears when framing migrants’ SRHR in relation to what is defined as honor-related violence and oppression. Furthermore, migrant SRHR issues are occasionally conceptualized as structural issues, as suggested by the human rights-based approach embraced by Swedish SRHR-related policies. Relevant structural factors, namely migration laws and regulations, are omitted when addressing, for example, human trafficking and HIV/AIDS.

Conclusions

We conclude that the dominant discourses favor depictions of migrants as vulnerable and as the Other. Moreover, despite the prevailing human rights-based discourse, structural factors are not always considered when framing and addressing migrants’ SRHR issues. This paper calls for a critical analysis of the concept of vulnerability in relation to migrants’ SRHR. It also highlights the importance of avoiding othering and paying attention to the structural factors when addressing migrants’ SRHR.

BACKGROUND: Only July 1, 2017, Nevada became the fifth US state to allow the legal sale of recreational cannabis products for adults ages of 21 and over. This study investigates young adults' cannabis-related attitudes, perceptions, and behaviors in a state where recreational and medical cannabis use was recently legalized.

METHODS: We conducted 8 focus groups stratified by cannabis use (regular users, occasional users, and nonusers) with 32 college students ages 18 to 24. Data were analyzed using the inductive qualitative thematic analysis method.

RESULTS: Four themes emerged during analyses: "sort of legal," "mitigating harm through legalization," "Increasing acceptance," and "seeking safety when purchasing cannabis." Despite their limited knowledge of cannabis regulation, the majority of the participants supported recreational cannabis legalization from a harm reduction perspective. Most participants did not believe that cannabis legalization had affected their use behavior. However, participants, especially cannabis users, perceived that recreational cannabis legalization created a context where cannabis use was legally, socially, and behaviorally "safer" than in an illegal context, even for those below the legal age of sale.

CONCLUSIONS: Most studies focus on the role of perceived health risk on cannabis use. If there are population-level long-term effects of recreational cannabis legalization on use behavior, findings suggest that they will be mediated by the perceived legal, social, and behavioral risk of using cannabis.

Frågor kring breddad rekrytering och breddat deltagande utgör en del av den sociala dimensionen av högre utbildning och är ett prioriterat område för det europeiska samarbetet. 2017 års förslag om att ändra i högskolelagen och vidga lärosätenas uppdrag till att aktivt främja ett brett deltagande gav upphov till en debatt bland såväl politiker som företrädare för lärosäten, vilken synliggjorde flera utmaningar, förhoppningar och farhågor. Föreliggande reflektion tar avstamp i denna debatt och fördjupar sig i frågor kring breddat deltagande för studenter med funktionsnedsättning. Syftet med reflektionen är att diskutera och reflektera kring vad breddat deltagande för denna målgrupp innebär och vilka krav det ställer på resurser, tillgänglighet, bemötande och attityder samt på högskolepedagogisk kompetensutveckling, kunskap om funktionsnedsättning och funktionshinder samt inkluderande pedagogik. Utgångspunkten för reflektionen är svensk forskning och pågående utvecklingsarbete om breddat deltagande för studenter med funktionsnedsättning samt författarnas erfarenhetsbaserade kunskaper om högskolepedagogisk undervisning och kompetensutveckling.

Bakgrund: Användningen av sociala medier har ökat kraftigt i vårt samhälle de senaste åren och ungdomar i åldern 12–25 är de största användarna. Samtidigt sker också en kraftig ökning av den psykiska ohälsan, speciellt hos unga. 

Syfte: Att genom en allmän litteraturstudie undersöka och sammanställa kunskap om hur sociala medier påverkar ungdomars psykiska hälsa.

Metod: En allmän litteraturstudie baserad på elva vetenskapliga texter. Datainsamlingen utfördes med hjälp av databaserna PsycINFO, PubMed och CINAHL. Därefter analyserades artiklarnas innehåll med hjälp av en kvalitativ innehållsanalys

Resultat: Användandet av sociala medier har visat sig kunna ha många fördelar för ungdomar. Trots de många fördelarna finns det också flera potentiella risker och nackdelar som kan påverka ungdomars hälsa och välbefinnande negativt. I resultatet framkom det också att det finns vissa faktorer som kan ha betydelse för hur effekten av användandet blir, till exempel hur mycket tid man spenderar på sociala medier eller om man som användare är passiv eller aktiv.

Slutsats: Studien bidrog med ökad kunskap om hur ungdomars psykiska hälsa kan påverkas av sociala medier. Kunskap som kan ge oss mer insikt i hur vi, på ett mer hälsofrämjande sätt, bör förhålla oss till sociala medier.

Consensual non-monogamy (CNM) involves being in a relationship that allows participants multiple concurrent sexual and/or intimate partners. Previous studies exploring attitudes toward different types of extra-dyadic sexual activity (EDSA) has typically distinguished between, on the one hand, polyamory/open relationships/swinging and, on the other, infidelity. The aim of this article is to develop further these discussions by showing how the distinctions between relationship types are drawn and/or blurred in social interactions, and how this requires moral work and negotiations of what ethical polyamory is. The research questions are as follows: 1. How are different CNM relationship types distinguished from each other, as well as intertwined and negotiated in social interactions? 2. How are ideals of consent, honesty, and communication reproduced and renegotiated in CNM relationships? 3. How does moral work become important for responding to negative attitudes toward CNM? The material consists of interviews with 22 persons practicing polyamory, CNM, or relationship anarchy, analyzed using thematic analysis. Results show that CNM relationship types are not clearly distinguishable but rather negotiated in social interactions both within a relationship and with others. Interviewees express that consent, honesty, and communication are central for their relationships, but also that they are negotiated. For example, honesty can be renegotiated by introducing an option of not telling your partner everything. Consent can also be renegotiated with some conditions, such as not actively searching out potential partners. They describe several different types of moral work: negotiating and reformulating others’ moral opinions, reversing moral hierarchies, and taking responsibility to explain and to soothe situations. These results contribute to existing research on attitudes toward CNM practices pointing out the importance of taking social interactions into account in order to explore the full extent of negative attitudes toward people involved in CNM relationships and how they handle these interactions.

Godnattsagor från insidan – familjepraktiker och affiniteter i familjer med frihetsberövade fäder 

Artikelns syfte är att utforska huruvida ett fängelseprojekt för att synliggöra barnlitteratur och läsning, Godnattsagor inifrån, kan bidra till att förbättra och bevara relationer mellan frihetsberövade fäder och deras barn. Analysen använder begreppen familjepraktiker och affiniteter. Materialet består av anonyma enkäter från de frihetsberövade fäderna (70) och omsorgsgivarna (46). Resultatet visar att djupare familjekontakt blir möjlig när fäder kan interagera med sina barn på ett sätt som inkluderar praktisk omsorg, till exempel att läsa en saga för barnet. Familjepraktikerna i projektet bidrar till att utmana normer kring maskulinitet och att undvika känslomässig avstängdhet. Projektet visar vikten av ett kriminalsystem och ett praktiskt socialt arbete som stöttar familjer i det svåra arbetet kring att forma och bevara nära kontakt. 

Norms concerning family formation are generally based on ideals of coupled love and the two-parent-family, however, family practices frequently go beyond these norms. Families consisting of more than two parents that are co-parenting have only been studied to a small extent. Analysing Swedish newspaper and magazine articles on more-than-two-parent families between 1992 and 2016 we ask: How are more-than-two-parent families displayed in Swedish media stories? Are they portrayed as legitimate families, and if so, how is this legitimacy discursively constructed? What role does recognition play in the media stories and how is it negotiated in the narratives? We use the concepts display (Finch 2007) and recognition/redistribution (Fraser 1998; 2003) in exploring the significance that recognition and legitimacy have for the depiction of families with more than two parents in the media material. The display of more-than-two-parent families in the Swedish media stories analysed is generally characterised by repertoires of modern family life, of love and intimacy and responsible and successful parenting. These repertoires are used to display the families as normal, modern, and legitimate. In addition to the repertoires mentioned, there are repertoires of importance of geographical location, of strategies and of critique of current legislation that further emphasise the legitimacy of the more-than-two-parent families in contrast to an outdated legislation that forces these legitimate families to strategise their intimate relationships. Despite several of the people interviewed being described as polyamorous or gay/lesbian, there are no tendencies in the empirical material to motivate the need for rights based on an essentialised polyamorous identity; rather, the focus is on the fact that it is the practical care relations that need to be protected.

Research on polyamorous parenthood has mainly focused on aspects of interactions with schools and authorities, where polyamorous parents have had to develop strategies of openness and concealment and dealing with stigmatization (Palotta-Chiarolla 2010; Riggs 2010; Sheff 2010). Aspects of sex and morality have primarily been explored in general in relation to non-monogamous practice and not specifically in relation to parenthood (Ritchie 2010; Samuels 2010). Based on interviews with 22 persons in Sweden who in different ways have experience of non-monogamous practice, we explore polyamorous parenthood, focusing on kinship practices, gender and sexual morality. The results of these analyses show that there are recurring themes of promiscuity as a risk that polyamorous parents have to handle. This can take the form of negative interactions with family members and society, practical issues with having sex with several partners or identity issues where good parenthood risks being at odds with non-monogamous practices. The boundaries of good parenthood and promiscuity and the negotiations between them are rarely highlighted in research, but have implications for the moral order of kinship for non-monogamous practice today. 

Polyamory means having a sexual and/or intimate relationship with more than one person at a time. In this study, we use in-depth interviews with 22 persons in Sweden who have experience of polyamorous or non-monogamous relationships to explore how polyamory can include imagining utopian relationships and spaces. Thematic analysis was done which indicated narratives of politically invested attempts to create communal living or societal change that resists capitalist and heteronormative nuclear-family arrangements as well as stories of everyday events that do not explicitly involve political ambitions. The range of utopian dreams and practices of the non-monogamous participants in our study, we argue, are examples of what Munoz calls concrete utopias, filled with joy and laden with disappointment in the face of potentiality and reality.

The aim of this literature study is to examine girls with autism and their school situation in Sweden. The study will therefore look at the girls' difficulties, possibilities and support when within the school environment. The present problem within the study theme is that there is a lack of research when it comes to the subject of girls with autism within the Swedish schools. Previous studies have shown that many students with autism in Sweden do not reach the knowledge goals during primary school and the schools do not adjust enough to the needs of the students with autism. Through using a qualitative method I do a deeper analysis of this specific subject group to see if I can find any reasons behind the problems surrounding them. The results of this study show that the schools do not have enough knowledge about what the diagnosis of autism means, specifically for the girls, or how to handle them correctly. In general the girls feel worse in comparison to the boys with autism when it comes to physical and psychological health. The girls also get less of the type and amount of support from school than boys with autism do. In conclusion I hope to bring awareness of the girls' situation and hope that my study can help encourage further studies about this subject.

Objectives: Opioid substitution treatment (OST) is often described as a strict and highly regulated treatment method, in which patients have limited influence over their treatment. In 2014, a reform was introduced by the regional council of Skåne in southern Sweden, which allowed OST patients to choose their treatment provider, thus transferring power from care providers to patients. The aim of this study was to examine what this increase in patient influence has meant for the clinics that provide OST in Skåne, and how these clinics have dealt with the new competitive situation that has arisen following the introduction of the reform. Methods: The study is based on two waves of semi-structured interviews with clinic managers at all OST clinics in Skåne. Results: The clinic managers described the increase in patient influence as a positive change, which had led to the patients being treated with more respect. The competition among clinics was expressed, among other things, in the form of differing views on the prescription of benzodiazepines, which initially gave rise to dissatisfaction among clinics with a more restrictive approach to such prescriptions. The reform did not lead to any clear diversity between clinics, apart from different approaches to the prescription of benzodiazepines. The incentive for competition-based diversity is, however, limited by the strict national regulatory system and by the reimbursement system, which restricts the ways in which clinics can conduct treatment activities. Conclusion: OST-clinic managers were largely positive about the increased patient empowerment and the shift in power balance associated with the patient choice reform. The introduction of the reform did not lead to any clear diversity between treatment providers, apart from differing views on the prescription of benzodiazepines, which by some managers was regarded as unfair competition. 

Problematic opioid use constitutes an extensive global problem. Correspondingly, opioid-related mortality is high and has increased in several Western countries, including Sweden, during the 2000s. In Sweden, the most effective treatment method, opioid substitution treatment (OST), was for a long time limited with respect to the number of patients. The treatment was also characterized by strict rules and conducted in a high-threshold manner, which has meant that it has not been fully appealing to people with problematic opioid use. Therefore, in Skåne County in southern Sweden, patient choice of treatment provider was introduced for OST in 2014 with the intention to increase the number of treatment places and strengthen patient empowerment. The overall aims of this thesis are (1) to investigate opioid-related deaths in Skåne with a focus on contact with care-providing authorities and in relation to increased access to OST, and (2) to examine patients’ and clinic managers’ attitudes towards the introduction of the patient choice reform for OST and their views of the reform's objectives of increased accessibility to OST and strengthening patients' empowerment and influence over their treatment.

The four papers in this thesis are based on two research projects with various empiric material. Paper I and II are based on data on opioid overdose deaths from a period of two years before and two years following the introduction of the patient choice reform. Forensic data regarding the presence of various substances and which opioid caused the death, as well as demographic data and information on contact with care-providing authorities (health care, social services, and the Prison and Probation Service), were collected. Paper I examines clinical background and contact with care-providing authorities of opioid-related fatalities, as well as differences with regard to which opioid caused the death. Paper II examines the possible impact of the intervention on the development of opioid-related deaths in the region. National mortality data were also used in this study to investigate the development in Skåne compared to the rest of Sweden. The second research project focused on stakeholders’ views on the implementation of the patient choice reform. Paper III includes interviews with 33 OST patients, and paper IV consists of interviews with the managers of all OST clinics in Skåne. The results from paper I show that of the 180 deceased in opioid overdose included in the study, almost 90 per cent had been in contact with one of the examined care-providing authorities during the year prior to death. Few differences appeared with regard to which opioid contributed to the death. Paper II indicates that there has been no significant change in opioid-related deaths in Skåne after the patient choice reform and increased access to OST. An analysis on national mortality data however showed a significant yearly decrease in drug-related deaths in Skåne compared to other Swedish counties in the years following the reform (2015–2017). No change was noted in deaths related to methadone or buprenorphine in Skåne. The proportion of deaths among patients in OST increased after the introduction of the reform. The third paper indicates that patients in OST in Skåne have gained increased empowerment and influence over their treatment since the patient choice reform was introduced. Patients especially appreciated the knowledge that they could make an exit and change clinics if they so wished, even if they so far had chosen not to. In paper IV, the clinic managers were largely positive to the trend towards increased influence for patients over their treatment situation. They were more critical of the fact that there was no major differentiation between treatment providers, and that the competition that arose after the patient choice reform mainly was related to prescribing benzodiazepines.

Conclusions drawn from the papers in this thesis include that patient choice of treatment provider can be viewed as a means of empowerment for patients in OST, which was regarded as positive by both patients and treatment providers. The limitations of such a system for providing OST that emerged were lack of diversity between clinics and that the competition between treatment providers largely comprised of differing views on the prescription of benzodiazepines. Further, improved access to low-threshold OST in Skåne was not associated with an increased overdose death-rate. The result that people who died from opioid overdose to a very large extent are known to society’s care-providing authorities suggests that there are considerable opportunities to reach people with problematic opioid use for therapeutic and harm reducing measures such as low-threshold OST and take-home naloxone.

Background Opioid-related mortality is high and increasing in the Western world, and interventions aimed at reducing opioid-related deaths represent an important area of study. In Skane County, Sweden, a patient choice reform resulted in increased access to opioid substitution treatment (OST). In addition, a gradual shift towards less restrictive terms for exclusion from OST has been implemented. The aim of this study was to assess the impact of these policy changes on opioid-related deaths. Methods Detailed data on opioid-related deaths in Skane during the 2 years prior to and following the policy change were obtained from forensic records and from health care services. Data on overdose deaths for Skane and the rest of Sweden were obtained using publicly available national register data. Time periods were used as the predictor for opioid-related deaths in the forensic data. The national level data were used in a natural experiment design in which rates of overdose deaths were compared between Skane and the rest of Sweden before and after the intervention. Results There was no significant difference in the number of deaths in Skane between the data collection periods (RR: 1.18 95% CI:0.89-1.57, p= 0.251). The proportion of deaths among patients enrolled in OST increased between the two periods (2.61, 1.12-6.10, p= 0.026). There was no change in deaths related to methadone or buprenorphine in relation to deaths due to the other opioids included in the study (0.92, 0.51-1.63, p= 0.764). An analysis of national mortality data showed an annual relative decrease in unintentional drug deaths in Skane compared to the rest of Sweden following the onset of the reform (0.90, 0.84-0,97, p= 0.004). Conclusions Opioid-related deaths, as assessed using forensic data, has not changed significantly in Skane following a change to lower-threshold OST. By contrast, national level data indicate that the policy change has been associated with decreased overdose deaths. The discrepancy between these results highlights the need for more research to elucidate this issue. The result that more patients die during ongoing OST following an increase in access to treatment underlines the need for further preventive interventions within the OST treatment setting.

Background Opioid-related deaths have increased in Western countries over recent decades. Despite numerous studies investigating opioid-related mortality, only a few have focused on the lives of the deceased individuals prior to their deaths, specifically regarding contact with care-providing authorities such as health, social and correctional services. Furthermore, a change has been noted in the last two decades as to which opioids cause most deaths, from heroin to prescription opioids. However, studies comparing fatalities caused by different substances are rare. The aim of this study was to investigate contact with care-providing authorities during the year prior to death among individuals who died as a result of opioid intoxication and to analyse differences relating to which opioids caused their deaths. Methods The study is based on retrospective register data and includes 180 individuals with a history of illicit drug use, who died from opioid intoxication in Skane, Sweden, between 1 January 2012 to 31 December 2013 and 1 July 2014 to 30 June 2016. Intoxications caused by heroin, methadone, buprenorphine and fentanyl were included. Data were collected from the National Board of Forensic Medicine, regional health care services, municipal social services and the Prison and Probation Service. Statistical testing was performed using Pearson's chi-square test, Fisher's exact test and the Mann-Whitney U test to analyse group differences. Results A total of 89% of the deceased individuals had been in contact with one or more of the care-providing authorities during the year prior to death; 75% had been in contact with health care, 69% with the social services, 28% with the Prison and Probation Service, and 23% had been enrolled in opioid substitution treatment at some point during their final year of life. Few differences appeared between the substance groups with regard to which opioid contributed to the death. In addition to opioids, sedatives were present in more than 80% of the cases. Individuals whose deaths were buprenorphine-related had been in contact with the social services to a significantly lesser extent during the year prior to death. Conclusions The studied population is characterised by extensive contact with care-providing authorities, thus providing numerous opportunities for authorities to reach this group with preventive and other interventions. Few differences emerged between groups with regard to which opioid had contributed to the death.