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Quarles van Ufford, S., Heimer, M., Schön, U.-K. & Linell, H. (2023). Discretion and Strategies for Investigating Child Abuse: Social Workers’ Conceptions of Child Abuse Investigations and Police Reporting. British Journal of Social Work
Open this publication in new window or tab >>Discretion and Strategies for Investigating Child Abuse: Social Workers’ Conceptions of Child Abuse Investigations and Police Reporting
2023 (English)In: British Journal of Social Work, ISSN 0045-3102, E-ISSN 1468-263XArticle in journal (Refereed) Published
Abstract [en]

Understanding the capacity of child welfare (CW) organisations to deal with child abuse is complex, and dependent on the specific CW context. Sweden occupies a unique position in trying to balance high demands for CW and protection with a strong family support focus, which carries a risk of overlooking children who need protection. Drawing on an understanding of social service organisations as street-level bureaucracies, this article explores discretion in child abuse cases by examining conditions affecting discretion and strategies for investigating child abuse, including police reporting. Thematic analysis of interviews with Swedish supervising social workers showed that staff’s conceptions of the CW system influenced the exercise of discretion, leading to different strategies for dealing with child abuse. This resulted in different practices and potentially unequal access to child protection and support, highlighting the wide margin of discretion. This article concludes that the interplay between knowledge and governance is central to equal child protection. This article contributes to the discussion of discretion in CW organisations by underlining the importance of being particularly vigilant about discretion when both children and parents are considered clients, as the child risks being lost as a subject with individual needs and rights.

Keywords
child abuse, child protection, child welfare, discretion, police report
National Category
Social Work
Identifiers
urn:nbn:se:du-47289 (URN)10.1093/bjsw/bcad243 (DOI)001102497900001 ()
Available from: 2023-11-21 Created: 2023-11-21 Last updated: 2023-12-11Bibliographically approved
Jones, A., Knutsson, O. & Schön, U.-K. (2022). Coordinated individual care planning and shared decision making: staff perspectives within the comorbidity field of practice: Personals perspektiv på samordnad individuell planering och delat beslutsfattande inom samsjuklighetsområdet. European Journal of Social Work, 25(2), 355-367
Open this publication in new window or tab >>Coordinated individual care planning and shared decision making: staff perspectives within the comorbidity field of practice: Personals perspektiv på samordnad individuell planering och delat beslutsfattande inom samsjuklighetsområdet
2022 (English)In: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664, Vol. 25, no 2, p. 355-367Article in journal (Refereed) Published
Abstract [en]

Integrated treatment is recommended for users with a comorbidity of mental illness and substance misuse. However, due to a divided support system, coordinated individual care planning (CIP) and user participation are emphasised to provide users with the necessary support. One way of increasing user participation is through shared decision making. However, the challenges are evident why coordination and user participation are not used in practice as intended. To contribute with knowledge to bridge the gap between the intended CIP process and practice, this study examined the problems and solutions perceived by staff. Future workshops were conducted with 17 staff members from social services and health care. Problems and solutions were identified within three main areas: organisation and staff knowledge, coordination among staff, and staff attitudes and user participation. The problems are in agreement with previous research, but this study contributes with knowledge regarding solutions. Overall, the solutions expressed relate to improving collaboration between providers and users and having more resources to conduct this work. However, the study also assents to the question if CIP is the best way to coordinate support or if integrated treatment should be the future. © 2021 Informa UK Limited, trading as Taylor & Francis Group.

Place, publisher, year, edition, pages
Routledge, 2022
Keywords
coordinated individual care planning, future workshops, mental illness, substance misuse, User participation
National Category
Nursing
Identifiers
urn:nbn:se:du-39280 (URN)10.1080/13691457.2021.2016649 (DOI)000731845000001 ()2-s2.0-85121690742 (Scopus ID)
Available from: 2022-01-07 Created: 2022-01-07 Last updated: 2023-04-14Bibliographically approved
Kylén, M., Schön, U.-K., Pessah-Rasmussen, H. & Elf, M. (2022). Patient Participation and the Environment: A Scoping Review of Instruments. International Journal of Environmental Research and Public Health, 19(4), Article ID 2003.
Open this publication in new window or tab >>Patient Participation and the Environment: A Scoping Review of Instruments
2022 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 4, article id 2003Article in journal (Refereed) Published
Abstract [en]

Patient participation and the environment are critical factors in achieving qualitative healthcare. We conducted a systematic scoping review using Arksey and O’Malley’s framework to identify instruments intended to measure patient participation. We assessed those instruments’ characteristics, which areas of the healthcare continuum they target, and whether environmental factors are considered. Instruments were considered eligible if they represented the patient perspective and measured patient participation in healthcare. The search was limited to articles written in English and published in the last 10 years. We extracted concepts (i.e., patient empowerment, patient participation, and patient-centeredness) based on the framework developed by Castro et al. and outcomes of significance regarding the review questions and specific objectives. The search was conducted in PsycINFO, CINHAL/EBSCO, and PubMed in September 2019 and July 2020. Of 4802 potential titles, 67 studies reported on a total of 45 instruments that met the inclusion criteria for this review. The concept of patient participation was represented most often in these studies. Although some considered the social environment, no instrument was found to incorporate and address the physical environment. Thirteen instruments were generic and the remaining instruments were intended for specific diagnoses or healthcare contexts. Our work is the first to study instruments from this perspective, and we conclude that there is a lack of instruments that measure aspects of the social and physical environment coherently as part of patient participation. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

Place, publisher, year, edition, pages
MDPI, 2022
Keywords
Environment, Healthcare, Patient participation, Patient-reported instruments, Scoping review, adult, environmental factor, female, human, male, Medline, outcome assessment, patient empowerment, PsycINFO, review, social environment, systematic review
National Category
Nursing
Identifiers
urn:nbn:se:du-39687 (URN)10.3390/ijerph19042003 (DOI)000767109500001 ()35206191 (PubMedID)2-s2.0-85124216585 (Scopus ID)
Available from: 2022-02-23 Created: 2022-02-23 Last updated: 2023-04-14Bibliographically approved
Osman, F., Schön, U.-K., Klingberg-Allvin, M., Flacking, R. & Tistad, M. (2022). The implementation of a culturally tailored parenting support programme for Somali immigrant parents living in Sweden: A process evaluation. PLOS ONE, 17(9), Article ID e0274430.
Open this publication in new window or tab >>The implementation of a culturally tailored parenting support programme for Somali immigrant parents living in Sweden: A process evaluation
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2022 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 17, no 9, article id e0274430Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Parental support programmes aim to strengthen family functioning and the parent-child relationship and to promote the mental health of children and parents. However, there is a lack of knowledge on how parenting support programmes can be implemented for newly arrived immigrant parents. This process evaluation describes the implementation of a successful parenting programme for immigrant parents from Somalia and identifies key components of the implementation process with a focus on Reach, Adaptation, and Fidelity of Ladnaan intervention.

METHOD: This process evaluation considered context, implementation and mechanism of impact, in accordance with the Medical Research Council's guidance. Data were collected through focus group discussions, a questionnaire, attendance lists, field and reflection notes and observations of the sessions. The data were then analysed using content analysis and descriptive statistics.

RESULTS: Of the 60 parents invited to the parenting programme, 58 participated in the sessions. The study showed that involving key individuals in the early stage of the parenting programme's implementation facilitated reaching Somali-born parents. To retain the programme participants, parents were offered free transportation. The programme was implemented and delivered as intended. A majority of the parents were satisfied with the programme and reported increased knowledge about children's rights and the support they could seek from social services.

CONCLUSIONS: This study illustrates how a parenting support programme can be implemented for Somali-born parents and provides guidance on how to attract immigrant parents to and engage them in participating in parenting support programmes.

National Category
Health Sciences Social Work
Identifiers
urn:nbn:se:du-42741 (URN)10.1371/journal.pone.0274430 (DOI)000954759700001 ()36103499 (PubMedID)2-s2.0-85138088838 (Scopus ID)
Available from: 2022-09-22 Created: 2022-09-22 Last updated: 2023-04-24Bibliographically approved
Quarles van Ufford, S., Heimer, M., Schön, U.-K. & Linell, H. (2022). The Swedish social services' police reporting and children's access to protection and support in child abuse cases: A quantitative content analysis.. International Journal of Child Abuse & Neglect, 133, Article ID 105828.
Open this publication in new window or tab >>The Swedish social services' police reporting and children's access to protection and support in child abuse cases: A quantitative content analysis.
2022 (English)In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 133, article id 105828Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The UN Convention on the Rights of the Child prohibits all forms of violence against children. Sweden was early in introducing a ban on disciplinary violence; however, difficulties have been noted in identifying children in need of protection and providing help for children exposed to violence.

OBJECTIVES: The purpose of this study was to explore the social services' police reporting and children's access to protection and support in cases of physical and sexual child abuse.

METHODS: The sample consisted of 291 child welfare reports from three Swedish municipalities. Data were collected from child welfare reports, investigations, and child social records and analyzed using quantitative content analysis.

RESULTS: A majority of the cases, including cases with a high indication for police reporting, were not reported to the police by the social services. Although the child in 60.1 % of cases provided information about violence, 70.7 % of all child welfare investigations were completed without support measures, and only 8.2 % led to protection or support linked to violence. Children's participation was limited, suggesting inadequate conditions for children's access to protection and support.

CONCLUSIONS: Children's right to protection against violence requires the recognition of children as active participants with access to safe participation. Failure to report suspected crimes against children risks minimizing acts of violence or making violence invisible. Difficulties in handling conflicts of interest between children and parents risk neither protection nor support being provided for the child.

Keywords
Child participation, Child protection, Child sexual abuse, Child welfare, Physical child abuse, Police report
National Category
Social Work
Identifiers
urn:nbn:se:du-42268 (URN)10.1016/j.chiabu.2022.105828 (DOI)000846679800006 ()35981440 (PubMedID)2-s2.0-85135905889 (Scopus ID)
Available from: 2022-08-26 Created: 2022-08-26 Last updated: 2023-03-23Bibliographically approved
Jones, A., Jess, K. & Schön, U.-K. (2021). How do users with comorbidity perceive participation in social services?: A qualitative interview study. International Journal of Qualitative Studies on Health and Well-being, 16(1), Article ID 1901468.
Open this publication in new window or tab >>How do users with comorbidity perceive participation in social services?: A qualitative interview study
2021 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 16, no 1, article id 1901468Article in journal (Refereed) Published
National Category
Nursing Social Work
Identifiers
urn:nbn:se:du-36779 (URN)10.1080/17482631.2021.1901468 (DOI)000631651700001 ()33752576 (PubMedID)2-s2.0-85103038886 (Scopus ID)
Available from: 2021-05-05 Created: 2021-05-05 Last updated: 2023-04-14Bibliographically approved
Grim, K., Tistad, M., Schön, U.-K. & Rosenberg, D. (2019). The legitimacy of user knowledge in decision-making processes in mental health care: An analysis of epistemic injustice. Journal of Psychosocial Rehabilitation and Mental Health, 6(2), 157-173
Open this publication in new window or tab >>The legitimacy of user knowledge in decision-making processes in mental health care: An analysis of epistemic injustice
2019 (English)In: Journal of Psychosocial Rehabilitation and Mental Health, ISSN 2198-9834, E-ISSN 2198-963X, Vol. 6, no 2, p. 157-173Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Springer, 2019
National Category
Health Sciences
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-30244 (URN)10.1007/s40737-019-00145-9 (DOI)2-s2.0-85079171838 (Scopus ID)
Note

Avtal Springer Compact

Available from: 2019-06-14 Created: 2019-06-14 Last updated: 2022-10-12Bibliographically approved
Schön, U.-K., Grim, K. & Wallin, L. (2018). Psychiatric service staff perceptions of implementing a shared decision-making tool: A process evaluation study. International Journal of Qualitative Studies on Health and Well-being, 13(1)
Open this publication in new window or tab >>Psychiatric service staff perceptions of implementing a shared decision-making tool: A process evaluation study
2018 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 13, no 1Article in journal (Refereed) Published
Abstract [en]

PURPOSE:

Shared decision making, SDM, in psychiatric services, supports users to experience a greater sense of involvement in treatment, self-efficacy, autonomy and reduced coercion. Decision tools adapted to the needs of users have the potential to support SDM and restructure how users and staff work together to arrive at shared decisions. The aim of this study was to describe and analyse the implementation process of an SDM intervention for users of psychiatric services in Sweden.

METHOD:

The implementation was studied through a process evaluation utilizing both quantitative and qualitative methods. In designing the process evaluation for the intervention, three evaluation components were emphasized: contextual factors, implementation issues and mechanisms of impact.

RESULTS:

The study addresses critical implementation issues related to decision-making authority, the perceived decision-making ability of users and the readiness of the service to increase influence and participation. It also emphasizes the importance of facilitation, as well as suggesting contextual adaptations that may be relevant for the local organizations.

CONCLUSION:

The results indicate that staff perceived the decision support tool as user-friendly and useful in supporting participation in decision-making, and suggest that such concrete supports to participation can be a factor in implementation if adequate attention is paid to organizational contexts and structures.

Keywords
Shared decision making; decision support tool; implementation; process evaluation; psychiatric services
National Category
Health Sciences
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-26828 (URN)10.1080/17482631.2017.1421352 (DOI)000424831900001 ()29405889 (PubMedID)2-s2.0-85045243442 (Scopus ID)
Available from: 2017-12-18 Created: 2017-12-18 Last updated: 2021-11-12Bibliographically approved
Grim, K., Rosenberg, D., Svedberg, P. & Schön, U.-K. (2017). Development and usability testing of a web-based decision support for users and health professionals in psychiatric services. Psychiatric rehabilitation journal, 40(3), 293-302
Open this publication in new window or tab >>Development and usability testing of a web-based decision support for users and health professionals in psychiatric services
2017 (English)In: Psychiatric rehabilitation journal, ISSN 1095-158X, E-ISSN 1559-3126, Vol. 40, no 3, p. 293-302Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Shared decision making (SMD) related to treatment and rehabilitation is considered a central component in recovery-oriented practice. Although decision aids are regarded as an essential component for successfully implementing SDM, these aids are often lacking within psychiatric services. The aim of this study was to use a participatory design to facilitate the development of a user-generated, web-based decision aid for individuals receiving psychiatric services. The results of this effort as well as the lessons learned during the development and usability processes are reported.

METHOD: The participatory design included 4 iterative cycles of development. Various qualitative methods for data collection were used with potential end users participating as informants in focus group and individual interviews and as usability and pilot testers.

RESULTS: Interviewing and testing identified usability problems that then led to refinements and making the subsequent prototypes increasingly user-friendly and relevant. In each phase of the process, feedback from potential end-users provided guidance in developing the formation of the web-based decision aid that strengthens the position of users by integrating access to information regarding alternative supports, interactivity between staff and users, and user preferences as a continual focus in the tool.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This web-based decision aid has the potential to strengthen service users' experience of self-efficacy and control as well as provide staff access to user knowledge and preferences. Studies employing participatory models focusing on usability have potential to significantly contribute to the development and implementation of tools that reflect user perspectives. (PsycINFO Database Record

National Category
Health Sciences
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-27766 (URN)10.1037/prj0000278 (DOI)000439151800005 ()28737415 (PubMedID)2-s2.0-85025153836 (Scopus ID)
Available from: 2018-06-05 Created: 2018-06-05 Last updated: 2021-11-12Bibliographically approved
Osman, F., Salari, R., Klingberg-Allvin, M., Schön, U.-K. & Flacking, R. (2017). Effects of a culturally tailored parenting support programme in Somali-born parents' mental health and sense of competence in parenting: a randomised controlled trial. BMJ Open, 7(12), Article ID e017600.
Open this publication in new window or tab >>Effects of a culturally tailored parenting support programme in Somali-born parents' mental health and sense of competence in parenting: a randomised controlled trial
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2017 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 7, no 12, article id e017600Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To evaluate the effectiveness of a culturally tailored parenting support programme on Somali-born parents' mental health and sense of competence in parenting.

DESIGN: Randomised controlled trial.

SETTING: A city in the middle of Sweden.

PARTICIPANTS: Somali-born parents (n=120) with children aged 11-16 years and self-perceived stress in their parenting were randomised to an intervention group (n=60) or a waiting-list control group (n=60).

INTERVENTION: Parents in the intervention group received culturally tailored societal information combined with the Connect parenting programme during 12 weeks for 1-2 hours per week. The intervention consisted of a standardised training programme delivered by nine group leaders of Somali background.

OUTCOME: The General Health Questionnaire 12 was used to measure parents' mental health and the Parenting Sense of Competence scale to measure parent satisfaction and efficacy in the parent role. Analysis was conducted using intention-to-treat principles.

RESULTS: The results indicated that parents in the intervention group showed significant improvement in mental health compared with the parents in the control group at a 2-month follow-up: B=3.62, 95% CI 2.01 to 5.18, p<0.001. Further, significant improvement was found for efficacy (B=-6.72, 95% CI -8.15 to -5.28, p<0.001) and satisfaction (B=-4.48, 95% CI -6.27 to -2.69, p<0.001) for parents in the intervention group. Parents' satisfaction mediated the intervention effect on parental mental health (β=-0.88, 95% CI -1.84 to -0.16, p=0.047).

CONCLUSION: The culturally tailored parenting support programme led to improved mental health of Somali-born parents and their sense of competence in parenting 2 months after the intervention. The study underlines the importance of acknowledging immigrant parents' need for societal information in parent support programmes and the importance of delivering these programmes in a culturally sensitive manner.

CLINICAL TRIAL REGISTRATION: NCT02114593.

Keywords
child protection, community child health, mental health, public health
National Category
Health Sciences
Research subject
Research Profiles 2009-2020, Health and Welfare
Identifiers
urn:nbn:se:du-26770 (URN)10.1136/bmjopen-2017-017600 (DOI)000423826700065 ()29222136 (PubMedID)2-s2.0-85050973636 (Scopus ID)
Note

Open Access APC beslut 26/2017

Available from: 2017-12-13 Created: 2017-12-13 Last updated: 2023-08-28Bibliographically approved
Projects
Socialtjänstens hantering av våld och barns tillgång till skydd och stödAtt undersöka genomförbarheten av att implementera ett hållbart kulturanpassad föräldrastödsprogram genom att använda processutvärdering
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3866-5636

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