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  • 1.
    Dahlqvist Jönsson, Patrik
    et al.
    Region Halland.
    Sandlund, Mikael
    Umeå Universitet.
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Svedberg, Petra
    Högskolan i Halmstad, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    The meaning of Shared decision making for persons with long-term mental illness2013Konferansepaper (Fagfellevurdert)
  • 2.
    Dahlqvist-Jönsson, Patrik
    et al.
    Region of Halland; Halmstad University.
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Rosenberg, David
    Umeå University.
    Sandlund, Mikael
    Umeå University.
    Svedberg, Petra
    Halmstad University.
    Service users’ experiences of participation in decision making in mental health services2015Inngår i: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 22, nr 9, s. 688-697Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Service user participation in decision making is considered an essential component of recovery-oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core category that emerged in the analysis described a ‘struggle to be perceived as a competent and equal person’ while three related categories including being the underdog, being controlled and being omitted described the difficulties of participating in decisions. The data analysis resulted in a model that describes internal and external conditions that influence the promotion of participation in decision making. The findings offer new insights from a user perspective and these can be utilized to develop and investigate concrete methods in order to promote user's participation in decisions.

  • 3. Grim, Katarina
    et al.
    Rosenberg, David
    Svedberg, Petra
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Development and usability testing of a web-based decision support for users and health professionals in psychiatric services2017Inngår i: Psychiatric rehabilitation journal, ISSN 1095-158X, E-ISSN 1559-3126, Vol. 40, nr 3, s. 293-302Artikkel i tidsskrift (Fagfellevurdert)
    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

  • 4.
    Grim, Katarina
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Rosenberg, David
    Svedberg, Petra
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Shared decision-making in mental health care: a user perspective on decisional needs in community-based services2016Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, artikkel-id 30563Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    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.

  • 5.
    Olsson, Helén
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Reducing violence in forensic care: how does it resemble the domains of a recovery-oriented care?2016Inngår i: Journal of Mental Health, ISSN 0963-8237, E-ISSN 1360-0567, Vol. 25, nr 6, s. 506-511Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Forensic psychiatry is characterized by involuntary treatment and risk of violence. The concept of recovery is rarely in focus as the primary focus is on risk assessment, violence prevention and reducing coercion in care.

    Aim: To determine what resources forensic staff use to avoid or prevent violent situations, and to explore how these practices resemble the domains of recovery-oriented care.

    Method: Semi-structured interviews with staff who were identified by forensic patients as key workers in their recovery process. Interview texts were analyzed using interpretive content analysis.

    Results: Staff prevent violent situations using tacit knowledge and experience, and through a shared collegial responsibility. Staff safeguard patients, encourage patient participation, and provide staff consistency.

    Conclusions: The results have implications for forensic care as well as psychiatry regarding the process of making recovery a reality for patients in the forensic care setting.

  • 6.
    Osman, Fatumo
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Flacking, Renée
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Klingberg-Allvin, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Ladnaan - att må bra: En utvärdering av ett riktat stöd till somaliska föräldrar i Borlänge Kommun2015Rapport (Annet vitenskapelig)
    Abstract [sv]

    Folkhälsomyndigheten har finansierat ett samarbetsprojekt mellan Borlänge kommun och Högskolan Dalarna för att anpassa och implementera ett föräldrastödsprogram till somaliska föräldrar, samt att mäta effekten av denna intervention avseende föräldrars och barns psykiska hälsa. Studien började med en explorativ delstudie med syfte att samla kunskap om vad somaliska föräldrar upplever som utmanande i sitt föräldraskap i Sverige, vilket behov av föräldrastöd de behöver samt hur ett sådant stöd ska vara utformat. Studien genomfördes med hjälp av fokusgruppsintervjuer med 23 föräldrar (15 mammor och 8 pappor) boende i Borlänge. Resultatet visade att föräldrarna upplevde en rad utmaningar i sin nya livssituation och i sitt föräldraskap i nya landet. De beskrev skillnader i synsätt på barnuppfostran och föräldraskap mellan hemlandet och Sverige och eftersträvade därför att kulturanpassa sitt föräldraskap.

    Resultaten från denna studie samt en genomgång av forskning kring föräldrastöd låg till grund för valet av föräldrastödsprogram samt ett samhällsorienterande tillägg till programmet.

     

    Målgrupp för studien var föräldrar med barn i åldrarna 11-16 år och som upplevde stress i sitt föräldraskap. Föräldrarna erbjöds sammanlagt 16 timmars utbildning fördelat på 12 träffar (10 timmar Connect föräldrastöd + 6 timmar samhällsorienterande tillägg). Effekten av föräldrastödet undersöktes genom en randomiserad kontrollerad studie där totalt 120 föräldrar ingick. De preliminära resultaten visar att deltagande föräldrars barn har förbättrats signifikant i subskalorna ”socialt” och ”skola”. Dessutom minskade barnens oro, somatiska problem, sociala problem och brytande av regler.

     

    Föräldrarna var nöjda med interventionen. De upplevde att de fått en ökad kunskap om hur socialtjänstens arbete fungerar och fått förtroende för deras arbete kring barn och unga. Över hälften av föräldrarna upplevde sig mer säkra i sin föräldraroll och att deras relation med barnen hade förbättrats.

     

    Genom en processutvärdering av implementeringen av föräldrastödet har framgångsfaktorer för genomförandet avföräldrastödsprogrammet studerats. Resultatet visade att de olika strategier som vidtagits vid rekrytering av föräldrar och implementering av interventionen har varit lyckade. Exempel på sådana strategier har varit att projektmedarbetarna som rekryterat till föräldrastödet har varit av Somaliskt ursprung, kursen har getts på somaliska men framförallt att föräldrastödet utgick ifrån föräldrarnas upplevda behov.

  • 7.
    Osman, Fatumo
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karolinska institutet.
    Flacking, Renée
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Klingberg-Allvin, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karolinska institutet.
    Effectiveness of parenting support to Somali parents on children’s mental health: A randomized controlled trial2016Konferansepaper (Fagfellevurdert)
  • 8.
    Osman, Fatumo
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Flacking, Renée
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Klingberg-Allvin, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    The impact of a culturally tailored parenting support for Somali-born parents’ and children’s mental health: A randomized controlled trial2017Konferansepaper (Fagfellevurdert)
  • 9.
    Osman, Fatumo
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Klingberg-Allvin, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Flacking, Renée
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Parenthood in transition: Somali-born parents' experiences of and needs for parenting support programmes2016Inngår i: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 16, nr 1, artikkel-id 82Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    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.

  • 10.
    Osman, Fatumo
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karolinska institutet.
    Salari, Raziye
    Klingberg-Allvin, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karolinska institutet.
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Flacking, Renée
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Effects of a culturally tailored parenting support programme in Somali-born parents' mental health and sense of competence in parenting: a randomised controlled trial2017Inngår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, nr 12, artikkel-id e017600Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 11.
    Rosenberg, David
    et al.
    Umeå universitet, Institutionen för socialt arbete.
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Återhämtning: Från idé till praktik2014Inngår i: Att leva med psykisk funktionsnedsättning: Livssituation och effektiva vård- och stödinsats / [ed] David Brunt och Lars Hansson, Lund: Studentlitteratur , 2014, 2Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 12. Rosenberg, David
    et al.
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Nyholm, Maria
    Grim, Katarina
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Svedberg, Petra
    Shared decision making in Swedish community mental health services - an evaluation of three self-reporting instruments.2017Inngår i: Journal of Mental Health, ISSN 0963-8237, E-ISSN 1360-0567, Vol. 26, nr 2, s. 142-149Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Despite the potential impact of shared decision making on users satisfaction with care and quality in health care decisions, there is a lack of knowledge and skills regarding how to work with shared decision making among health care providers.

    AIM: The aim of this study was to evaluate the psychometric properties of three instruments that measure varied dimensions of shared decision making, based on self-reports by clients, in a Swedish community mental health context.

    METHOD: The study sample consisted of 121 clients with experience of community mental health care, and involved in a wide range of decisions regarding both social support and treatment. The questionnaires were examined for face and content validity, internal consistency, test-retest reliability and construct validity.

    RESULTS: The instruments displayed good face and content validity, satisfactory internal consistency and a moderate to good level of stability in test-retest reliability with fair to moderate construct correlations, in a sample of clients with serious mental illness and experience of community mental health services in Sweden.

    CONCLUSIONS: The questionnaires are considered to be relevant to the decision making process, user-friendly and appropriate in a Swedish community mental health care context. They functioned well in settings where non-medical decisions, regarding social and support services, are the primary focus. The use of instruments that measure various dimensions of the self-reported experience of clients, can be a key factor in developing knowledge of how best to implement shared decision making in mental health services.

  • 13. Rosenberg, David
    et al.
    Svedberg, Petra
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Establishing a recovery orientation in mental health services: Evaluating the Recovery Self-Assessment (RSA) in a Swedish context2015Inngår i: Psychiatric rehabilitation journal, ISSN 1095-158X, E-ISSN 1559-3126, Vol. 38, nr 4, s. 328-335Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: Although there has been an emphasis on developing knowledge regarding recovery in Sweden, it is unclear to what extent this has been translated into a recovery orientation in the provision of mental health services. Instruments, which present the components of recovery as measurable dimensions of change, may provide a framework for program development. Involving users is an essential factor in the utilization of such tools. The purpose of this study was to evaluate the psychometric properties of the Recovery Self-Assessment (RSA) measure and its potential for being utilized in a Swedish context. Methods: The sample consisted of 78 participants from 6 community mental health services targeting people with serious mental illnesses in a municipality in Sweden. They completed the RSA at the study baseline and two weeks later. User panels participated in the translation and administration of the RSA and the reporting of results. Results: The Swedish version of the RSA had good face and content validity, satisfactory internal consistency, and a moderate to good level of stability in test-retest reliability. The user panels contributed to establishing validity and as collaborators in the study. Conclusions and Implications for Practice: Establishing the RSA as a valid and reliable instrument with which to focus on the recovery orientation of services is a first step in beginning to study the types of interventions that may effect and contribute to recovery oriented practice in Sweden. © 2015 American Psychological Association.

  • 14.
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Hälsa och samhälle, Socialt arbete.
    Brukarmedverkan i en evidensbaserad praktik2012Konferansepaper (Fagfellevurdert)
    Abstract [sv]

    Bakgrund

    När det gäller stöd och service till människor med psykisk ohälsa finns idag en förhållandevis god kunskap om människors möjligheter till återhämtning från allvarliga psykiska besvär (Schön, 2009; Slade 2011; Topor 2004). Faktorer som brukarmedverkan, kontinuitet, sociala relationer är några av de faktorer som identifieras som grundläggande i en återhämtningsprocess (a.a). Fortfarande är dock brukarmedverkan i socialtjänsten en begränsad praktik och relativt outforskat. Trots att det på senare år allt mer påtalats att socialtjänstens praktik behöver bli en ”evidensbaserad” praktik är användandet av brukarkunskap i socialtjänstens en saknad del i en sådan kunskapsutveckling (McLaughlin, 2011). En evidensbaserad praktik definieras ofta som att bestå av ”tre ben” bästa tillgängliga kunskap, de professionella samt brukarnas kunskaper och önskemål. Brukarmedverkan i denna process innebär att brukare och deras närstående inte bara ses som aktörer i en politisk process, utan också som en omistlig kunskapskälla med erfarenheter och perspektiv viktiga för en bred kunskapsbildning (Socialstyrelsen 2005).

    Argument och fokus för brukarmedverkan kan relateras till tre områden, nämligen frågor relaterade till demokrati (Dahlberg & Vedung, 2001), frågor relaterade till makt och egenmakt (Beresford et al, 2008; Beresford 2010) samt frågor relaterade till tjänsters utveckling (Barnes et al 2000), där utvecklingen av en evidensbaserad social service ingår. Vissa forskare menar att socialtjänstens utveckling, i likhet med andra områden såsom t ex vård och omsorg, under senare år har präglats av en stark individualisering och valfrihets ambition utifrån en top-down perspektiv, vilket anses ha överskuggat den demokratiska eller "bottom-up"-strategi som är mer kritisk och främjande av social förändring och social rättvisa (Beresford 2010; Ferguson, 2008). I Storbritannien t ex har t ex brukarmedverkan setts som framgångsrikt om deltagande har varit framgångsrik i motsats till att fokusera på resultat eller effekt av detta deltagande för t ex utvecklingen av tjänster eller forskning (Carr 2004; McLaughlin, 2009).

    Syfte

    Syftet med detta projekt är att studera och utveckla kunskapsområdet brukarmedverkan i socialtjänstens praktik. Detta ska ske genom en kunskapsöversikt av betydelsen av brukarmedverkan i socialtjänstens praktik. Ett annat syfte är att pröva om, och i så fall hur, brukarkunskap påverkar kunskapsområdet genom att göra erfarenhetsbaserad kunskap tillgänglig för lärande för studenter, yrkesverksamma och för forskare inom socialt arbete. Ett ytterligare syfte är att undersöka vad brukarmedverkan i en sådan erfarenhetspanel kan innebära för enskildas återhämtningsprocesser från psykisk ohälsa. 

  • 15.
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Can gender sensitivity in psychiatry improve recovery?2012Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Introduction: In recent years research on recovery have resulted in new knowledge and gained relevance in the mental health field. Still recovery is discussed in terms of individual journeys to find ways to live a hopeful and satisfying life. Taking the concept of gender into consideration it is possible to begin to address additional questions about how women and men influence their recovery; how they perceive and understand the society in which they live, and how they are likely to be regarded and treated within that society.

    Methods: In a study conducted in Sweden 30 first-person accounts of recovery from mental illness were examined. The study was undertaken to determine if there was gender diversity in what people described as being decisive factors for their recovery.

    Results: The results illustrates a gender advantage for the men in their ability to make use of the psychiatric services offered in their coping strategies mainly focusing on remission, education and control over symptoms. The women, on the other hand, described hospitalization and psychiatric medication more in terms of coercion and helplessness. These results may raise the need for a gender perspective in psychiatry to reduce the female impediment to access to safe and effective psychiatric care. But the results also illustrate how gender norms, outside psychiatry, benefit women more than men in a recovery perspective. In spite of structural gender inequalities, female gender norms seemed to be an advantage in the recovery process. The female recovery process was focused on making sense and meaning, whereas the male recovery process was focused on reinforcement of traditional roles such as occupation and independence. The women also had a higher capacity to receive and maintain support from their social networks than did the men.

  • 16.
    Schön, Ulla-Karin
    Stockholms universitet, Institutionen för socialt arbete - Socialhögskolan.
    How men and women in recovery make meaning to severe mental illness2009Inngår i: Journal of Mental Health, ISSN 0963-8237, E-ISSN 1360-0567, Vol. 18, nr 5, s. 433-440Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Creating a new meaning of the illness, changing values and expectations due to the illness are seen as important factors in recovery from mental illness.

    Aims: In this study, conducted in Sweden, male and female meaning making of severe mental illness is explored and how these meanings compass the recovery process.

    Method: Through 30 in-depth interviews male and female meaning of mental illness are explored through a grounded theory analysis. Results: In the process of making meaning illness reason emerged as the core category. But the reasons differed both in relation to gender and within the two genders. Four patterns of response were found in the analysis of the material. These four patterns influenced how the recovery process was encompassed. Three of the four groups were restructing the meaning of the illness in a more favorable way contributing to a redirection of life towards authenticity.

    Conclusions: The results underline a demand for further research on recovery achievements connected to meaning making and changes in attitude. One such area is to create a meaning in one’s life where gender is reconsidered in relation to the individual’s capacity and life situation.

  • 17.
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Hälsa och samhälle, Socialt arbete.
    Kunskapsbaserad praktik och brukarmedverkan för att stödja människors återhämtning från psykisk ohälsa2011Inngår i: Hälsa, Livskvalitet och Välfärd. Forskningskonferens, Falun, 2011Konferansepaper (Annet vitenskapelig)
    Abstract [sv]

    Bakgrund Behovet av en evidensbaserad praktik påtalas allt mer. Det handlar bland annat om ett behov av att implementera ny kunskap, att systematiserat följa upp de insatser som ges, och i högre utsträckning inkludera brukaren i insatsernas utformning. I dag är kunskapen fortfarande begränsad kring betydelsen av brukarmedverkan både för verksamhetsutveckling och för den enskildes livskvalitet och upplevelse av tjänsterna. När det gäller stöd och service till människor med psykisk ohälsa har faktorer som brukarmedverkan, kontinuitet, sociala relationer identifierats som grundläggande i återhämtningsforskningen. Men denna kunskap har i mycket begränsad omfattning fått implikationer på politik och praktik. Det saknas metoder och system för en evidensbaserad psykiatri och socialtjänst till stöd för människors återhämtning från psykisk ohälsa. Syfte Projektet ska studera former för brukarmedverkan i en kunskapsbaserad praktik. Den centrala forskningsfrågan handlar sålunda om brukarmedverkan kan bidra till verksamhetsutveckling och förbättra den enskildes livskvalitet och upplevelse av tjänsterna. Om systematiserade mätningar av brukarupplevelse påverkar de insatser som ges till människor med psykisk ohälsa, med speciellt fokus på samspelet mellan individens erfarenhetskunskap och personalens bemötande och verksamheters utbud. Projektets syfte och forskningsfråga rymmer även ett återhämtningsperspektiv i vilket ovanstående frågor studeras utifrån grundantagandet att en ökad brukarmedverkan bidrar till ökade möjligheter till återhämtning. I projektet planeras tre delstudier, var och en med sin speciella fokusering när det gäller kunskap, implikationer för praktiken och individers möjligheter till återhämtning. Metod Delstudie 1 är en kvalitativ litteraturstudie. Delstudie 2 har en explorativ ansats där en erfarenhetspanel planeras samt brukarerfarna forskningspartners. Fokusgruppsintervjuer samt individuella intervjuer kommer att genomföras. Delstudie 3 är en kvantitativ studie där en validerad skattningsskala, Inspire 3.0, kommer att användas.

  • 18.
    Schön, Ulla-Karin
    Stockholms universitet, Institutionen för socialt arbete - Socialhögskolan.
    Kvinnors och mäns återhämtning från psykisk ohälsa2009Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    The overall aim with this thesis is to describe and analyze women’s and men’s recovery processes. More specifically, the aim is to determine what women and men with experience of mental illness describe as contributing to the personal recovery process. The point of departure for the studies was 30 in-depth interviews conducted with 15 men and 15 women. The selection of interview subjects was limited to individuals who had been treated in 24-hour psychiatric care and diagnosed as having schizophrenia, psychosis, a personality disorder, or a bipolar disorder.

     

    Four studies have been carried.  Study 1 was a baseline article that examined what people in recovery from mental illness outline as facilitating factors to their recovery. The results that emerged from that study indicated areas for further analysis to condense the understanding of the recovery process. In study 2 the similarities and the differences in recovery described by women and men were examined. In Study 3 women’s and men’s meaning-making with reference to severe mental illness facilitate the recovery process were studied. The forth study explored how peer-support contribute to women’s and men’s recovery from mental illness.

     

    The results emphasize recovery from mental illness as a social process in which relationships play a key role in creating new identities beside the mental illness. For a majority of the participants meeting peers facilitated the recovery process. The participants described how peer support meant an end to isolation and became an arena for identification, connection, and being important to others. Throughout these recovery processes the impact of gender has been emphasized. The results from this thesis provide new insight into gender as an important factor in understanding the recovery processes. The results from the four studies emphasize the mental patient, the psychiatric interventions and the individual recovery strategies as being influenced by gender constructions.

  • 19.
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Psychosocial interventions; collaboration and shared decision-making?: A participatory research project to develop and implement shared decision-making in psychiatric services2015Konferansepaper (Fagfellevurdert)
  • 20.
    Schön, Ulla-Karin
    Stockholms universitet, Institutionen för socialt arbete - Socialhögskolan.
    Recovery from mental illness, a gender perspective2010Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, nr 3, s. 557-564Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background and research objectives: Recovery from mental illness is an individual process characterized by regaining a positive sense of self and developing a new meaning. Knowledge concerning differences between male and female recovery processes is, however, limited. The objective of this study was to determine gender diversity in what individuals described as decisive factors for their recovery.

     

    Subjects and methods:  In this qualitative study based on grounded theory 30 first-person accounts of recovery from mental illness are examined. After informed consent data were collected through in-depth interviews with people in recovery from psychosis, bipolar disorders or personality disorders.

     

    Results: The results show that in spite of structural gender inequalities, female gender norms seem to be an advantage in the recovery process. The female participants were focused on making sense and meaning in their recovery process, while the male participants were focused on control over symptoms and reinforcement of traditional roles such as occupation and independence. Another result showed psychiatric hospitalization to mainly contribute to male recovery processes.

     

    Conclusion: These results provide new insights into gender as an important factor in understanding recovery processes and in providing care to facilitate these processes.

  • 21.
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Recovery in involuntary psychiatric care: is there a gender difference?2013Inngår i: Journal of Mental Health, ISSN 0963-8237, E-ISSN 1360-0567, Vol. 22, nr 5, s. 420-427Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Research on recovery from mental illness and the influence of compulsory psychiatric institutional care has revealed the complexity of this concept. There is also limited knowledge regarding the impact of gender-role expectations in these contexts, and how such expectations may influence both the care and individuals’ recovery processes.

    Aim: To explore women’s and men’s perceptions of the impact of compulsory inpatient care on recovery from severe mental illness.

    Method: Grounded theory was used to analyse 30 first-person accounts of recovery from mental illness, elicited via interviews with individuals who had been compulsorily treated in hospital and diagnosed with a severe mental illness.

    Results: Inpatient care at an early stage was crucial for the informants’ recovery. However, there was ambivalence in their perceptions of the impact of compulsory inpatient care. The narratives confirmed gender differences as well as gender stereotypes.

    Conclusions: The results have implications for recovery research, in that they emphasise the importance of understanding recovery as a gender-influenced process.

  • 22.
    Schön, Ulla-Karin
    Department of Social Work, Stockholm University, Stockholm, Sweden.
    The power of identification: Peer support in recovery from mental illness2010Inngår i: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 12, nr 2, s. 83-90Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Abstract: Peer support has been described as facilitating individuals’ recovery from mental illness and offer useful support, hope and encouragement. The aim of this study was to explore how individuals with experience of severe mental illness in Sweden perceived peer support facilitating their recovery.

    The results from the grounded theory analysis of 24 in depth interviews illustrated that despite diagnoses of severe mental illness, often described in terms of an inability to interact with other people, the identification when meeting others with similar experiences was powerful. The participants described how peer support meant an end to isolation and became an arena for identification, normalization, connection and being important to others. Involvement in the peer support group was related to time and recovery stage, the participants pay attention to their own achievements in relation to peers and their recovery progress, comparing their level of wellness with that of their peers.

  • 23.
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    User and carer involvement in social work education: reasons for participation2016Inngår i: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 18, nr 2, s. 154-163Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In many countries, user involvement in social work (SW) education is common practice, while in other countries, initiatives for inclusion are currently expanding. No matter how far the progress of user involvement in education has come, issues on clarity, sustainability and accountability need to be addressed. In this paper, users’ reasons for wanting to participate in SW education and the way they define their potential contribution are explored. These experiences can provide important information contributing to sustainable, meaningful, and accountable collaborations between users, university staff and students. Participants (n = 33) answered a questionnaire including demographic data and four open-ended questions about their expectations of participation in a SW programme at the University of Dalarna in Sweden. The results from the open-ended questions were analysed using qualitative content analysis. Results show that users’ main reasons for wanting to get involved were to contribute through sharing their lived experience of SW education, to help improve services and also to obtain respect for their own personal knowledge and experience. The respondents described themselves both as carriers of valuable knowledge and as accountable experts on the subject.

  • 24.
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    User involvement in social work and education: a matter of participation?2016Inngår i: Journal of Evidence-Informed Social Work, ISSN 2376-1407, E-ISSN 2376-1415, Vol. 13, nr 1, s. 21-33Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The increase in user involvement in social work practice and education can be explained by incentives toward an evidence-based practice, such as those offered by legislation and from the user movement, and those related to professional development. Still, the clients' involvement in research and practice is highlighted as a gap that needs to be filled. The aim of the author in this article is to study the presence of user involvement in social work practice, research, and education, and the level of influence of users and carers within these activities. The results reflect an expanding user involvement in social work practice. Still, projects of user involvement in social work practice are often developed on an ad hoc and inconsistent basis, and knowledge about the effects of these efforts is still limited. User involvement is not to be understood as something that is self-evidently good. On the contrary, the results present a rather complex concept that is bound up with changing and contested understandings of the role of the social worker, academia, and the users themselves.

  • 25.
    Schön, Ulla-Karin
    Högskolan Dalarna, Akademin Hälsa och samhälle, Socialt arbete.
    Vad avses med återhämtning från psykisk ohälsa?2012Inngår i: Rehabilitering och stöd till återhämtning vid psykiska funktionshinder: möjlighetens metoder för en ny praktik / [ed] Ershammar, David; Bogarve, Camilla; Rosenberg, David, Stockholm: Gothia förlag , 2012Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 26.
    Schön, Ulla-Karin
    et al.
    Department of Social Work, Stockholm University, Sweden.
    Denhov, Anne
    Research and Development Unit, Psychiatry, SLSO, Stockholm South, Sweden.
    Topor, Alain
    Department of Social Work, Stockholm University, Sweden.
    Social relationships as a decisive factor in recovering from severe mental illness2009Inngår i: International Journal of Social Psychiatry, ISSN 0020-7640, E-ISSN 1741-2854, Vol. 4, nr 55, s. 336-347Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Recovery research often describes recovery from mental illness as a complex individual process. In this article a social perspective on recovery is developed.

    Aims: To ascertain which factors people regard as decisive to their own recovery and what makes them beneficial.

    Methods: In-depth interviews were conducted with 58 persons in Sweden who had recovered from severe mental illness. Interviews were qualitatively analyzed using grounded theory.

    Results: Three dimensions of contributing recovery factors were identified. Social relationships emerged as the core category throughout these dimensions.

    Conclusions: The results show that recovery processes are social processes in which social relationships play a key role.

  • 27.
    Schön, Ulla-Karin
    et al.
    Department of Social Work, Stockholm University, Sweden.
    Denhov, Anne
    Research and Development Unit, Psychiatry, SLSO, Stockholm South, Sweden.
    Topor, Alain
    Department of Social Work, Stockholm University, Sweden.
    Social relationships as a decisive factor in recovering from severe mental illness2009Inngår i: International Journal of Social Psychiatry, ISSN 0020-7640, E-ISSN 1741-2854, Vol. 4, nr 55, s. 336-347Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Recovery research often describes recovery from mental illness as a complex individual process. In this article a social perspective on recovery is developed.

    Aims: To ascertain which factors people regard as decisive to their own recovery and what makes them beneficial.

    Methods: In-depth interviews were conducted with 58 persons in Sweden who had recovered from severe mental illness. Interviews were qualitatively analyzed using grounded theory.

    Results: Three dimensions of contributing recovery factors were identified. Social relationships emerged as the core category throughout these dimensions.

    Conclusions: The results show that recovery processes are social processes in which social relationships play a key role.

  • 28.
    Schön, Ulla-Karin
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Grim, Katarina
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete. Karlstad universitet.
    Wallin, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Psychiatric service staff perceptions of implementing a shared decision-making tool: A process evaluation study2018Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 13, nr 1Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 29.
    Schön, Ulla-Karin
    et al.
    Högskolan Dalarna, Akademin Hälsa och samhälle, Socialt arbete.
    Rosenberg, David
    Umeå universitet.
    Transplanting Recovery? Research and practice in the Nordic countries2013Inngår i: Tenth International Conference of the European Network For Mental Health Service Evaluation: Abstract book, 2013, s. 205-205Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background/ObjectivesThe conceptual framework which describes recovery from mental illness is based primarily on studies conducted in English-speaking countries. Knowledge and development of a recovery orientation within other cultures and mental health systems is still limited, and few studies have discussed the impact of varied national contexts on the development and implementation of recovery-oriented services. The aim of this study was to compile, describe and discuss the research on personal recovery and recovery oriented practice within the psychiatric and social fields in the Nordic countries. MethodsA systematic literature review of Nordic research on recovery from mental illness was conducted which included studies that clearly focused on Recovery as a knowledge base in psychiatric and social services.ResultsTwenty one studies were reviewed, summarized and analyzed with regard to their findings regarding the recovery process, descriptions of interventions which promote recovery and factors which might be specific to the Nordic context and mental health system. The majority of the studies were qualitative and stressed the importance of social relations, environmental factors and peer support. The identified research literature was limited and primarily replicated designs and confirmed findings first presented in North American and British studies. Few studies referred to aspects of welfare system, mental health service structures or cultural factors that might impact the recovery process.Discussion/ConclusionThere is a need to identify and describe factors in Nordic mental health systems that may influence the recovery process. If research does not attend to cultural and organizational differences that may impact the development and implementation of recovery services there is a risk that users will not gain access to these interventions in a manner relevant to their needs. A corresponding challenge will be to translate and further develop outcome indicators that can promote a recovery oriented health system.

  • 30.
    Schön, Ulla-Karin
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Rosenberg, David
    Department of Social Work, Umeå University, Umeå, Sweden .
    Transplanting recovery?: Research and practice in the Nordic countries2013Inngår i: Journal of Mental Health, ISSN 0963-8237, E-ISSN 1360-0567, Vol. 22, nr 6, s. 563-569Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The conceptual framework which describes recovery from mental illness is based primarily on studies conducted in English-speaking countries. Knowledge and development of recovery orientation within other cultures and mental health systems is still limited.

    Aim: The aim of this study was to compile, describe, and discuss the research on personal recovery and recovery-oriented practice within the psychiatric and social fields in the Nordic countries.   

    Method: A systematic literature review of Nordic research on recovery from mental illness.

     

    Results: The research literature is limited, and primarily replicates designs and confirms findings first presented in studies conducted in the USA and Great Britain.

    The majority of the studies are qualitative, and point to the importance of social relations, environmental factors, and peer support.

     

    Conclusions: There is a need to identify and describe factors in Nordic mental health systems that may influence the recovery process. A corresponding challenge will be to translate and further develop outcome indicators that can promote a recovery-oriented health system.

  • 31.
    Schön, Ulla-Karin
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Svedberg, Petra
    Högskolan i Halmstad.
    Rosenberg, David
    Umeå Universitet.
    Evaluating the INSPIRE measure of staff support for personal recovery in a Swedish psychiatric context2015Inngår i: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 69, nr 4, s. 275-281Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Recovery is understood as an individual process that cannot be controlled, but can be supported and facilitated at the individual, organizational and system levels. Standardised measures of recovery may play a critical role in contributing to the development of a recovery-oriented system. The INSPIRE measure is a 28-item service user-rated measure of recovery support. INSPIRE assesses both the individual preferences of the user in the recovery process and their experience of support from staff.

    Aim: The aim of this study was to evaluate the psychometric properties of the Swedish version of the INSPIRE measure, for potential use in Swedish mental health services  and in  order to promote recovery in mental illness.

    Method: The sample consisted of 85 participants from 6 community mental health services targeting people with a diagnosis of psychosis in a municipality in Sweden. For the test-retest evaluation 78 participants completed the questionnaire two weeks later.   

    Results: The results in the present study indicate that the Swedish version of the INSPIRE measure had good face and content validity, satisfactory internal consistency and some level of instability in test-retest reliability.

    Conclusions: While further studies that test the instrument in a larger and more diverse clinical context are needed, INSPIRE can be considered as a relevant and feasible instrument to utilize in supporting the development of a recovery-oriented system in Sweden.

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