Är den tillämpade idrottsforskningen könsneutral? : Fallstudie på en tidskrifts publikationer

Syfte Mötet mellan kroppen som något socialt format och som något biologiskt mätbart som sker i idrott kan vara problematiskt vilket visat sig genom tidigare forskning inom området. Olika sätt att se på kön kan göra att biologisk jämlikhet mellan män och kvinnor förutsätts där det finns skillnader eller att skillnader förutsätts där det inte finns några. Syftet med denna studie var att genom en systematisk litteraturgranskning belysa det tillämpade idrottsvetenskapliga forskningsfältets urval av försökspersoner och rapportering av dessa. Samt utifrån teorier kring kön och genus tolka resultatet av detta. Vidare var syftet att undersöka effekten av förstaförfattarens könskategori på val av urvalsgrupper och rapportering av dessa. Studien tar bland annat sin utgångspunkt i Hirdmans formler för förhållandet mellan man och kvinna för att analysera de resultat som fås. Tas både kulturella och biologiska aspekter på kroppen i beaktning i den idrottsvetenskapliga forskning som sker som sedan skall tillämpas i praktiken? Metod Genom en fallstudie av en idrottsvetenskaplig tidskrift som publicerar studier inom den tillämpade idrottsvetenskapliga forskningen kodades dess publicerade artiklar. Totalt kodades 291 artiklar som hörde till original investigations, case studies och technical reports. Särskild vikt lades vid de kodade artiklarnas sammanfattning och urval av försökspersoner varför titel, sammanfattning, sökord och könskategori på förstaförfattare kodades. Även könsfördelning på försökspersonerna i urvalsgruppen och totalt antal försökspersoner kodades.  Resultat I häften av alla artiklar gick könsfördelning inte att utläsa i sammanfattning. Totalt identifierades 8643 försökspersoner varav 4191 var av manligt kön, 1440 av kvinnligt kön och 3012 gick inte att koda till en könskategori. Fler än 50 % av artiklarna identifierades med ett urval av enbart män, 6 % med ett urval av enbart kvinnor, 21 % blandat urval och resterande gick inte att koda. I 84 % av fallen identifierades förstaförfattare som man. Slutsats Vid en första anblick av en artikel kan det vara svårt att bilda sig en uppfattning kring könsfördelning på studiens urvalsgrupp. Urvalsgrupperna är inte jämnt fördelade mellan kvinnor och män. En skev rekrytering av urvalet kan ge upphov till att den idrottsvetenskapliga forskningen speglar idrottens premisser att det är en manlig arena. På detta sätt riskerar den att reproducera den manliga normen inom idrotten genom att påverka framtida forskning eller idrottsutbildningar.

Faktorer av betydelse för livskvalitet efter stroke ur ett patientperspektiv : en systematisk litteraturstudie

Stroke är en allvarlig sjukdom som betraktas som den främsta orsaken till funktionsnedsätt-ning i vuxen ålder och kräver flest vårddagar på sjukhus. Syftet med denna studie var att analysera vilka faktorer som har betydelse för en persons livskvalitet efter genomgången stroke samt möjligheter för hälso- och sjukvårdspersonal att underlätta för strokepatienten att återfå sin livskvalitet. Studien genomfördes som en sammanställning av litteraturen med induktiv ansats där författarna granskade fyra studier med kvalitativ design och nio studier med kvantitativ design. Utmaningarna efter stroke är många för den som insjuknat. Livskvalitet påverkas inte enbart av de fysiska funktionsnedsättningar som stroke medför utan även av psykiska och sociala faktorer som till exempel depression, ångest, brist på socialt umgänge och fritidsaktiviteter. Kunskap, motivation och stöd var avgörande faktorer under återhämtningen och påverkade patientens följsamhet till rehabiliteringen. Studiens resultat visade att KUNSKAP om sjuk-domen, rehabiliteringen och de resurser som fanns att tillgå under den krävande återhämtningsprocessen var en viktig faktor för att strokepatienter skulle uppleva meningsfullhet med tillvaron och på så sätt uppleva livskvalitet. Kunskap ökade i sin tur MOTIVATIONEN vilket bidrog till att patienter valde att fortsätta vilja och orka återfå förlorade funktioner. För att detta skulle vara möjligt måste personer som drabbats av stroke erhålla STÖD i form av hjälp från familj och vänner samt olika insatser från hälso- och sjukvården.

Att prata ihop sig i rätten

Negotiating experience in the court How do judges assess witness credibility, and how do they proceed to reach sustainable conclusions in a criminal court? This article is based on discussions in four focus groups with lay judges in Swedish district courts. In criminal court trials, a version of an event is generally reinforced if it is confirmed by witnesses. However, if their narratives are too similar, none of them is found trustworthy. The focus group participants agreed that if witnesses were suspected of having discussed their individual experiences of an event and accommodated them into a common story, their testimonies were not considered credible. While testimonies should ideally be untainted by other people’s impressions and opinions, other rules govern the truth of the court. The lay judges appreciated their deliberations, including negotiations on impressions and memories of the trial, and they sometimes adjusted their perceptions in the light of information provided by other members of the court. However, if the lay judges are viewed as witnesses of what takes place in the trial, this gives rise to a paradox: While witness negotiations on experiences are regarded as a means to construct a false or biased story, the same kind of interaction between the judges is considered necessary to establish a consensual truth of what actually happened.

Existential issues in surgical care : Nurses’ experiences and attitudes in caring for patients with cancer

The overall aim of this thesis was to explore surgical nurses’ experiences of being confronted with patients’ existential issues when caring for patients with cancer, and to examine whether an educational intervention may support nurses in addressing existential needs when caring for patients with cancer. Previously recorded discussions from supervision sessions with eight healthcare professionals were analysed (I), written descriptions of critical incidents were collected from 10 nurses, and interviews with open questions were conducted (II). An educational intervention on existential issues was pilot tested and is presented in Studies III and IV. The intervention was the basis of a pilot study with the purpose of testing whether the whole design of the educational intervention, including measurements instruments, is appropriate. In Study III and IV interviews with 11 nurses were conducted and 42 nurses were included in the quantitative measurements of four questionnaires, which were distributed and collected. Data was analysed using qualitative secondary analysis (I), hermeneutical analysis (II), and mixed methods using qualitative content analysis and statistical analyses (III-IV). Results in all studies show that existential issues are part of caring at surgical wards. However, although the nurses were aware of them, they found it difficult to acknowledge these issues owing to for example insecurity (I-III), a strict medical focus (II) and/or lacking strategies (I-III) for communicating on these issues. Modest results from the pilot study are reported and suggest beneficial influences of a support in communication on existential issues (III). The results indicate that the educational intervention may enhance nurses’ understanding for the patient’s situation (IV), help them deal with own insecurity and powerlessness in communication (III), and increase the value of caring for severely ill and dying patients (III) in addition to reducing work-related stress (IV). An outcome of all the studies in this thesis was that surgical nurses consider it crucial to have time and opportunity to reflect on caring situations together with colleagues. In addition, descriptions in Studies III and IV show the value of relating reflection to a theory or philosophy in order for attitudes to be brought to awareness and for new strategies to be developed.

Understanding older people’s experiences of home care through the capability approach

The core concepts of CA In the theoretical framework of CA, well-being is constituted by a person’s unique way of functioning and capabilities. This means that a person's well-being is personal and involves freedom of choice which in turn means they have a number of options. Although many people may have the same resources, it is of importance to study how these resources are converted into how they function. Thus, wellbeing is about the person's freedom to achieve in general and the capabilities to function in particular (Sen, 1995). Strength of the capability approach The capability approach is a useful tool for matching objective evaluations with subjective metrics. Furthermore, although one’s individual abilities are in focus, contextual factors, and subjective perceptions and experiences, are taken into consideration. Critiques against the CA The capability approach has been criticized for being too individual-centered and not taking sufficient account to social structures in society. It is difficult to know what a person would choose to do if other options were available. Therefore, to operationalize abilities involves uncertainties.

Improving continence services for older people from the service-providers’ perspective : a qualitative interview study

Objective: To examine in depth the views and experiences of continence service leads in England on key service and continence management characteristics in order to identify and to improve our understanding of barriers to a good-quality service and potential facilitators to develop and to improve services for older people with urinary incontinence (UI). Design: Qualitative semistructured interviews using a purposive sample recruited across 16 continence services. Setting: 3 acute and 13 primary care National Health Service Trusts in England. Participants: 16 continence service leads in England actively treating and managing older people with UI. Results: In terms of barriers to a good-quality service, participants highlighted a failure on the part of commissioners, managers and other health professionals in recognising the problem of UI and in acknowledging the importance of continence for older people and prevalent negative attitudes towards continence and older people. Patient assessment and continence promotion regardless of age, rather than pad provision, were identified as important steps for a good-quality service for older people with UI. More rapid and appropriate patient referral pathways, investment in service capacity, for example, more trained staff and strengthened interservice collaborations and a higher profile within medical and nurse training were specified as being important facilitators for delivering an equitable and highquality continence service. There is a need, however, to consider the accounts given by our participants as perhaps serving the interests of their professional group within the context of interprofessional work. Conclusions: Our data point to important barriers and facilitators of a good-quality service for older people with UI, from the perspective of continence service leads. Further research should address the views of other stakeholders, and explore options for the empirical evaluation of the effectiveness of identified service facilitators.

Using structured observation and content analysis to explore the presence of older people in public fora in developing countries

There is a lack of research on the everyday lives of older people in developing countries. This exploratory study used structured observation and content analysis to examine the presence of older people in public fora, and considered the methods’ potential for understanding older people’s social integration and inclusion. Structured observation occurred of public social spaces in six cities each located in a different developing country, and in one city in the United Kingdom, together with content analysis of the presence of people in newspaper pictures and on television in the selected countries. Results indicated that across all fieldwork sites and data sources, there was a low presence of older people, with women considerably less present than men in developing countries. There was variation across fieldwork sites in older people’s presence by place and time of day, and in their accompanied status. The presence of older people in images drawn from newspapers was associated with the news/non-news nature of the source. The utility of the study’s methodological approach is considered, as is the degree to which the presence of older people in public fora might relate to social integration and inclusion in different cultural contexts.

Att lämna en värld : Om utgångsprocesser ur Jehovas vittnen

It is an everyday experience to realize that things do not turn out the as expected. But what if you realize that everything you have so far experienced as reality is illusion? This article is about former members of the Jehovah’s Witnesses who have had doubts about what they previously believed to be the Truth. The article also treats the exit process, from being a Jehovah’s Witness to becoming an ex-Jehovah’s Witness. The data consists of twenty qualitative interviews with ten Jehovah’s Witnesses and twenty qualitative interviews with ten former Jehovah’s Witnesses. The data also include a diary written during four years preceding an exit from the organization. The analysis was made through thematic concentration. Ontologically the analysis and the article are based on a constructionist view though it is mainly empirical with no further theoretical assessment. However, to be able to understand the results a contextual frame is sketched with two factors affecting members who make an exit. First there are tying factors that bind the person closer to the organization; these are closeness and friendship and confirmation. A secluding factor is something that secludes the member from the outside society; these factors are the work situation and »closed doors«. With high values on these factors the exit process will be more arduous. The results are presented through a process model in which different phases or steps in the exit process are described. The following steps in the process are: (1) different levels of doubts; (2) trying out doubts; (3) turning points; (4) different decisions; (5) different steps in execution; (6) floating; (7) relative neutrality. The process is defined as an altogether ambivalent and emotionally tough experience, but other parts of life may be affected as well, such as employment, social life, family life and career.

Assessing the physical environment of older people’s residential care facilities: development of the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM)

Background There is emerging evidence that the physical environment is important for health, quality of life and care, but there is a lack of valid instruments to assess health care environments. The Sheffield Care Environment Assessment Matrix (SCEAM), developed in the United Kingdom, provides a comprehensive assessment of the physical environment of residential care facilities for older people. This paper reports on the translation and adaptation of SCEAM for use in Swedish residential care facilities for older people, including information on its validity and reliability. Methods SCEAM was translated into Swedish and back-translated into English, and assessed for its relevance by experts using content validity index (CVI) together with qualitative data. After modification, the validity assessments were repeated and followed by test-retest and inter-rater reliability tests in six units within a Swedish residential care facility that varied in terms of their environmental characteristics. Results Translation and back translation identified linguistic and semantic related issues. The results of the first content validity analysis showed that more than one third of the items had item-CVI (I-CVI) values less than the critical value of 0.78.  After modifying the instrument, the second content validation analysis resulted in I-CVI scores above 0.78, the suggested criteria for excellent content validity. Test-retest reliability showed high stability (96% and 95% for two independent raters respectively), and inter-rater reliability demonstrated high levels of agreement (95% and 94% on two separate rating occasions). Kappa values were very good for test-retest (κ= 0.903 and 0.869) and inter-rater reliability (κ= 0.851 and 0.832). Conclusions Adapting an instrument to a domestic context is a complex and time-consuming process, requiring an understanding of the culture where the instrument was developed and where it is to be used. A team, including the instrument’s developers, translators, and researchers is necessary to ensure a valid translation and adaption. This study showed preliminary validity and reliability evidence for the Swedish version (S-SCEAM) when used in a Swedish context. Further, we believe that the S-SCEAM has improved compared to the original instrument and suggest that it can be used as a foundation for future developments of the SCEAM model.

Shared decision-making in mental health care : a user perspective on decisional needs in community-based services

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.

Parenthood in transition : Somali-born parents' experiences of and needs for parenting support programmes

BACKGROUND: Pre- and post-migration trauma due to forced migration may impact negatively on parents' ability to care for their children. Little qualitative work has examined Somali-born refugees' experiences. The aim of this study is to explore Somali-born refugees' experiences and challenges of being parents in Sweden, and the support they need in their parenting. METHODS: A qualitative descriptive study was undertaken. Data were collected from four focus group discussions (FGDs) among 23 Somali-born mothers and fathers living in a county in central Sweden. Qualitative content analysis has been applied. RESULTS: A main category, Parenthood in Transition, emerged as a description of a process of parenthood in transition. Two generic categories were identified: Challenges, and Improved parenting. Challenges emerged from leaving the home country and being new and feeling alienated in the new country. In Improved parenting, an awareness of opportunities in the new country and ways to improve their parenting was described, which includes how to improve their communication and relationship with their children. The parents described a need for information on how to culturally adapt their parenting and obtain support from the authorities. CONCLUSIONS: Parents experienced a process of parenthood in transition. They were looking to the future and for ways to improve their parenting. Schools and social services can overcome barriers that prevent lack of knowledge about the new country's systems related to parenthood. Leaving the home country often means separation from the family and losing the social network. We suggest that staff in schools and social services offer parent training classes for these parents throughout their children's childhood, with benefits for the child and family.

Tough, sensitive and sincere : how adolescent boys manage masculinities and emotions

This study aimed to explore adolescent boys’ views of masculinity and emotion management and their potential effects on well-being. Interviews with 33 adolescent boys aged 16–17 years in Sweden were analysed using grounded theory. We found two main categories of masculine conceptions in adolescent boys: gender-normative masculinity with emphasis on group-based values, and non-gender-normative masculinity based on personal values. Gender-normative masculinity comprised two seemingly opposite emotional masculinity orientations, one towards toughness and the other towards sensitivity, both of which were highly influenced by contextual and situational group norms and demands, despite their expressions contrasting each other. Non-gender-normative masculinity included an orientation towards sincerity emphasising the personal values of the boys; emotions were expressed more independently of peer group norms. Our findings suggest that different masculinities and the expression of emotions are strongly intertwined and that managing emotions is vital for well-being.

Hur fem mammor som utsatts för sexuella övergrepp i barndomen upplever sin föräldraroll

Det är allmänt känt att sexuella övergrepp i barndomen kan leda till en rad psykosociala svårigheter samt psykisk ohälsa. Trots att forskningen i ämnet har intensifierats de senaste åren är det fortfarande ett kunskapsområde där mycket saknas. Detta är en kvalitativ uppsats med syftet att återge fem mammors upplevelser av hur sexuella övergrepp i barndomen påverkat deras uppfattning av sin föräldraroll. Genom att intervjua dessa kvinnor med hjälp av ett frågeformulär med öppna frågor har vi fått tagit del av hur deras traumatiska erfarenheter har påverkat deras föräldraroll. Mammornas berättelser har analyserats med hjälp av meningskoncentrering. Resultatet av intervjuerna har tolkats för att sedan jämföras med vad tidigare forskning samt litteratur i ämnet har att skildra. Undersökningen visar att de sexuella övergreppen i kvinnornas barndom påverkat dem negativt i sina föräldraroller. I undersökningen framkommer även att dessa mödrar känt en avsaknad av stöd då deras barn varit små.

Hip-hop and Construction of Group Identity in a Stigmatized Area. : A Field Study regarding Cultural Capital among Roma Youths in Konik, Montenegro.

This research aimed for an extended knowledge and understanding of young people in stigmatized areas and their construction of group identity. With a focus on Roma youths in Konik, Montenegro, and their involvement in hip-hop we wanted to explore what this culture meant to them in relation to their context. An ethnographic approach was used in collecting the empirical data through observations, interpreting music lyrics and conducting qualitative semi-structured interviews. Five young Roma boys from Konik, all involved in hip-hop, were interviewed. Theoretical perspectives on identity, youth culture and stigmatization were central. In addition, Bourdieu’s theory regarding cultural capital was emphasized and connected to youths and hip-hop. The empirical material showed that involvement in hip-hop provided the Roma youths with a group identity that they referred to in positive terms. Contextual factors of stigmatization excluded the Roma group from the majority population and the engagement in hip-hop created a possibility for the youths to be someone. The cultural capital gained through hip-hop was not used to verify and legitimate an authentic Roma identity. It was rather a way for them to create boundaries towards the negative elements in their community.