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Background Menopause will personally affect half the population and can cause severe symptoms and increase long-term health risks. Despite this, gaps in menopausal knowledge and unequal access to menopausal healthcare have been identified in Sweden. Limited knowledge among women undermines informed choice and delays care-seeking. To address these gaps, this study purports to critically examine how menopause is represented in Swedish digital health communication and to explore the implications for informed choice and equitable care. In Sweden, the Patient Act and national quality standards guarantee accessible, evidence-based information to support autonomy and equity. It remains unclear whether these principles are met in Sweden's primary official digital healthcare platform (1177.se).

Aim To analyse how menopause is discursively constructed on Sweden's primary official digital healthcare platform (1177.se) and to examine implications for informed choice and health equity.

Method Fairclough's Critical Discourse Analysis guided interpretation of 1177.se texts on menopause across three levels: text, discursive practice and social practice. Analytical rigour was upheld through reflexive practice and theoretical triangulation, achieved via continuous dialogue among the authors.

Results Six intersecting discourses were identified: gendered minimisation, gatekeeping, risk-framing, neoliberal individualism, heteronormativity and intersectional exclusion. These discourses oversimplify complexity, privilege selective biomedical knowledge and moralise personal responsibility, limiting autonomy and health literacy. Such patterns contradict the principles of knowledge-based, equitable care outlined in the Swedish Patient Act and the EU Gender Equality Strategy.

Conclusion Menopause communication on 1177.se reflects systemic tensions between governance ideals and discursive realities. To fulfil policy mandates and advance equity, digital health communication must integrate precise terminology, multilingual access, balanced risk/benefit framing and inclusive perspectives.

The objective of this prospective cohort study was to explore parents' perspectives of patients' experiences of the first available novel disease-modifying therapy for SMA in Sweden. Patients with SMA and their parents/legal guardians were identified in the National Patient Register and the Multi-Generation Register. Data was recorded using an electronic questionnaire administered at baseline, and after 6, 12, and 18 months. In total, 47 parents to 33 children with SMA (mean patient age: 9 years, 59% female; 27% with SMA type I, 33% with type II, and 39% with type III) participated. All parents reported that they wished their child to be treated with nusinersen and most parents (81%) reported that they had sufficient information to make an informed treatment decision. Across follow-up, almost all parents reported having a positive experience of nusinersen. Our study provides unique insights into caregivers' real-world experiences of a novel disease-modifying therapy for SMA.

Objectives. There is a lack of family-based psychosocial support interventions in palliative care when a parent of children or youths has a life-threatening illness. One intervention that has shown positive effects is the family talk intervention (FTI). This study aimed to describe the influence of contextual factors on FTI sustainability, as perceived by healthcare professionals (HCPs), after a median of 18 months of implementation in clinical practice in cancer and palliative care when a parent of children or youths has a life-threatening illness.

Methods. Focusgroups and individual interviews were conducted with 15 HCPs working with FTI. Data were analyzed using conventional qualitative content analysis.

Results. HCPs identified contextual factors that facilitated or hindered the use of FTI. The analysis resulted in 3 categories, Trying to prioritize FTI and coordinate families in a complex context is challenging, Working alone without FTI-educated colleagues hampers sustainability, the satisfaction of seeing families become stronger contributes to a receptiveness for change.

Significance of the results. This study shows that organizational support and resources, alongside the individual’s facilitating factors, such as receptiveness for change, are crucial for sustainability after the initial implementation. Witnessing a positive impact is motivational and also supports the sustainability of an intervention despite contextual constraints.

Families affected by cancer need psychosocial support, however few family interventions have been scientifically evaluated. The Family Talk Intervention (FTI) was pilot tested in pediatric oncology with 26 families. Issues raised and addressed during FTI meetings were explored by analyzing hospital social workers' (HSWs) fieldnotes. The findings show a range of severity in the family issues raised. These encompassed families' wellbeing, communication, conflicts, strengths, and needs for further support. Findings indicate that FTI can be a structured, yet flexible, way for HSWs to identify and address the complex psychosocial needs of these families.

Background: The Family Talk Intervention (FTI) is a psychosocial intervention supporting families where a family member has palliative care needs. This study aimed to evaluate how the Family Talk Intervention (FTI) was implemented over time from the perspective of hospital social workers (HSWs) in their everyday clinical practice among families with a severely ill parent or child in need of palliative care.

Methods: HSWs (n = 21) working in adult and children's care completed a 10-day education where they were trained to use FTI. The education was part of a multifaced implementation strategy involving educational outreach visits, facilitation, clinical implementation meetings, and audit and feedback. The HSWs were then expected to use FTI in their clinical practice to support families with dependent children. To assess if and how FTI was integrated into their daily practice, they were also asked to complete the Swedish version of the Normalization Process Theory Measure (S-NoMAD) on three occasions: on completion of the FTI-education, six months later, and one year later. For the longitudinal analysis of data, Friedman's test was used.

Results: The HSWs rated the use of FTI high after completing the FTI-education, indicating a positive attitude towards FTI. In the longitudinal analysis, statistically significant changes were seen for two questions in S-NoMAD, where the HSWs' ratings showed that the FTI became more familiar and normalized over time. Generally, the HSWs' ratings of S-NoMAD's main constructs were high and stable over time, indicating a positive view of FTI and its implementation. However, for the single questions, the ratings were slightly more negative to some contextual aspects, such as managerial support and resources.

Conclusion: As results showed, HSW mainly rated different aspects of the implementation process as positive, both from the beginning, but also over time. Therefore, the intervention could be judged to have been implemented as a tool to support families when a parent or a child is severely ill. Contextual factors, involving managerial support and resources were rated lower, indicating the importance of those aspects when introducing interventions into healthcare. The result also indicates that the multifaced implementation strategy supported the HSW's everyday clinical practice.

Clinical Trial Registration: clinicaltrials, nr, identifier (NCT05365919; 2022-03-04 and; NCT05020158 2021-05-11).

Background Communication is central to implementing palliative care (PC) and effective interdisciplinary team functioning. Communication about existential issues is often urgent in PC, yet interdisciplinary teams frequently lack the time and education to meet these communication needs. Thus, more knowledge of existential conversations indifferent PC contexts is required.

Aim This study aimed to gain an in-depth understanding of healthcare professionals’ (HCPs) experiences of existential conversations with patients with PC needs and their next-of-kin by generating a theoretical model.

Method Seven focus-group interviews that included 26 HCPs who worked with PC patients in different care settings were carried out in 2020 and 2022. The grounded theory method was used to analyse and compare data from the interview transcripts.

Results The HCPs’ primary concern in daily work was establishing a trusting relationship, a prerequisite for enabling existential conversations with a person with PC needs and/or their next-of-kin. The main concern was characterised by the core category maintaining presence and four categories describing interdisciplinary strategies that the HCPs used to achieve a trusting relationship and enable existential conversations in the late phase of life. Several potential barriers also hindered existential conversations. The theoretical model ‘meaningful existential conversations in PC’ was constructed.

Conclusions The interdisciplinary strategies used to establish existential conversations, the potential barriers to these conversations and the model we present can be used as a basis for reflection in professional collaborative learning in PC, as a tool for teachers in educational PC programmes and as a guide for HCPs in PC.

Background and purpose: The psychosocial needs of migrant families affected by a child’s severe illness are extensive. However, few family-centred interventions have been evaluated and even fewer have included families with migrant backgrounds. The aim of this study was, therefore, to explore migrant fami-lies’ experiences of participating in a family-centred psychosocial intervention, the Family Talk Intervention (FTI), in a paediatric care setting.

Material and methods: In this study, semi-structured interviews were performed with 14 family members (six parents, one ill child, and seven siblings) after participating in FTI. The interviews were transcribed and analysed using thematic network analysis.

Results: After participating in FTI, the families experienced that, in their already exposed situation, their family stability had increased as they were supported in dealing with social and financial issues, encouraged to talk openly about difficulties, and thus became closer as a family. Both children and parents described the value of having someone professional, continuously available, to turn to for guidance and information.

Interpretation: Migrant families dealing with a child’s severe illness live in an exposed situation, with a double burden of distress related to the child’s illness and socioeconomic factors. By acknowledging the importance of these families’ psychosocial needs, it could be recognised that psychosocial support, such as FTI, not only aids family adjustment but also contributes to reducing this double burden, increasing family stability.