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Selvin, M., Almqvist, K., Kjellin, L., Lundqvist, L.-O. & Schroder, A. (2019). Patient and staff experiences of quality in Swedish forensic psychiatric care: a repeated cross-sectional survey with yearly sampling at two clinics. International Journal of Mental Health Systems, 13, Article ID 8.
Open this publication in new window or tab >>Patient and staff experiences of quality in Swedish forensic psychiatric care: a repeated cross-sectional survey with yearly sampling at two clinics
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2019 (English)In: International Journal of Mental Health Systems, ISSN 1752-4458, E-ISSN 1752-4458, Vol. 13, article id 8Article in journal (Refereed) Published
Abstract [en]

BackgroundSystematic efforts to improve the quality, safety and value of health care have increased over the last decades. Even so, it is hard to choose priorities and to know when the desired results are reached, especially in forensic psychiatric care where there can be a discrepancy between patient and staff expectations of what good quality of care is and how it should be reached. The aim of the present study was to describe and compare patient and staff experiences of quality of care in two forensic psychiatric clinics over a period of 4years.MethodsA quantitative design was used and yearly between 2011 and 2014, a total of 105 questionnaires were answered by patients and 598 by staff.ResultsThe sample consisted of four different groups; patient and staff in Clinic A and Clinic B respectively. The repeated measurements showed that quality of care, as described by the patients, varied over time, with significant changes over the 4years. The staff evaluations of the quality of care were more stable over time in both clinics compared with the patients. Generally, the staff rated the quality as being better than the patients but these differences tended to decrease when efforts were made to improve the care.ConclusionsIt is important to highlight both what staff and patients perceive as both high and low quality care. With regular measurements and sufficient resources, training, support and leadership, the chances of successful improvement work increase. This knowledge is important in forensic nursing practice, for teaching and for management and decision makers in the constant work of improving forensic psychiatric care.

Place, publisher, year, edition, pages
BMC, 2019
National Category
Psychology
Research subject
Psychology with an emphasis on medical psychology
Identifiers
urn:nbn:se:kau:diva-71095 (URN)10.1186/s13033-019-0265-z (DOI)000457489600001 ()30733827 (PubMedID)
Available from: 2019-02-14 Created: 2019-02-14 Last updated: 2019-02-21Bibliographically approved
Pernebo, K., Fridell, M. & Almqvist, K. (2019). Reduced psychiatric symptoms at 6 and 12 months’ follow-up of psychotherapeutic and psychoeducative group interventions for children exposed to intimate partner violence. International Journal of Child Abuse & Neglect, 93, 228-238
Open this publication in new window or tab >>Reduced psychiatric symptoms at 6 and 12 months’ follow-up of psychotherapeutic and psychoeducative group interventions for children exposed to intimate partner violence
2019 (English)In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 93, p. 228-238Article in journal (Refereed) Published
Abstract [en]

Background: Long-term follow-up studies of interventions for children exposed to intimate partner violence are few, and the sustainability of their outcomes often remains unexplored and uncertain. Current research including follow-up assessment suggests that treatment gains may be maintained or continue post termination. In addition some children may show increased levels of symptoms. Objective: The present effectiveness study investigated the long-term outcomes of two established group interventions for children exposed to intimate partner violence and their non-offending parent. Participants and Setting: The study included 50 children, 24 girls and 26 boys, aged 4 to 13 years attending a psychotherapeutic child and adolescent mental health service intervention and a psychoeducative community-based intervention. Methods: Background information, child and parental mental health problems, trauma symptoms, and exposure to violence were assessed pre- and post treatment and at 6 and 12 months’ follow-up. Results: Sustained treatment gains and late improvements in children's internalizing and externalizing symptoms and in symptoms of traumatic stress were recorded from post treatment to the follow-up assessments (p =.004–.044; d = 0.29–0.67). No significant increase in symptoms was reported. Additionally, very little continued or renewed child exposure to violence was reported. Conclusions: The results of the study indicate that the children did benefit from the two interventions studied and that the outcomes of reduced child symptoms and protection from exposure to violence were sustainable. Children with severe trauma symptoms benefited the most, though maternal psychological problems may for some have hindered recovery. Clinical implications are discussed.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Children, Follow-up, Group intervention, Intimate partner violence, Post-traumatic stress, Treatment
National Category
Psychiatry Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-72512 (URN)10.1016/j.chiabu.2019.05.002 (DOI)2-s2.0-85065829855 (Scopus ID)
Available from: 2019-06-13 Created: 2019-06-13 Last updated: 2019-06-13Bibliographically approved
Anderzen-Carlsson, A., Gillå, C., Lind, M., Almqvist, K., Lindgren Fändriks, A. & Källström, Å. (2018). Child healthcare nurses' experiences of asking new mothers about intimate partner violence. Journal of Clinical Nursing, 27(13-14), 2752-2762
Open this publication in new window or tab >>Child healthcare nurses' experiences of asking new mothers about intimate partner violence
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2018 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 13-14, p. 2752-2762Article in journal (Refereed) Published
Abstract [en]

Aims and objectives: To investigate child healthcare nurses' experiences of asking mothers of 8-month-old children about intimate partner violence using a two-step questionnaire. Background: Exposure to intimate partner violence is detrimental to women and to their children, and its early detection is vital. Child health care is a promising setting for detecting intimate partner violence. Design: The overall project had a quasi-experimental design and was employed in 2015 at 12 child healthcare centres in Sweden. The project aimed to test a two-step method for talking about intimate partner violence with mothers (n = 198) at the child healthcare centre. In this article, we disclose the experiences of the intervention from the perspective of the nurses (n = 13) who were educated and involved in the intervention. Methods: Data were collected by semi-structured interviews, analysed by thematic analysis. Results: Five categories emerged: using the two-step questionnaire method, asking about IPV as an important issue, being comfortable in the professional role and with asking about IPV, the importance of time and place in asking about IPV and spillover effects. Conclusions: Asking mothers visiting the child health clinic about their experiences of intimate partner violence was seen as an important task. Using a questionnaire could facilitate asking, but the questionnaire must be short and easy to use. Furthermore, the time and place for initiating a talk about this sensitive topic must be carefully chosen. Relevance to clinical practice: The Violence in Families questionnaire was regarded as a useful tool and could thus be implemented in practice. However, it is important to offer education to the nurses prior to implementing a routine of asking about intimate partner violence in the child healthcare setting.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
Child healthcare clinics, Intimate partner violence, Nursing, Qualitative methods, article, child, child health care, clinical practice, education, experimental design, family violence, female, human, human experiment, major clinical study, mother, nurse, partner violence, pediatric hospital, professional standard, qualitative analysis, questionnaire, semi structured interview, Sweden, thematic analysis
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-66213 (URN)10.1111/jocn.14242 (DOI)000435942000025 ()2-s2.0-85041099584 (Scopus ID)
Available from: 2018-02-09 Created: 2018-02-09 Last updated: 2019-03-13Bibliographically approved
Almqvist, K., Bäccman, C., Anderzen-Carlsson, A., Norlén, A., Pernebo, K. & Massoudi, P. (2018). iRiSk II: Utveckling av bedömningsinstrument och stödinsatser för våldsutsatta barn - rapport fråm två delprojekt. Karlstads universitet
Open this publication in new window or tab >>iRiSk II: Utveckling av bedömningsinstrument och stödinsatser för våldsutsatta barn - rapport fråm två delprojekt
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2018 (Swedish)Report (Other academic)
Place, publisher, year, edition, pages
Karlstads universitet, 2018. p. 34
Series
Arbetsrapport
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-67325 (URN)978-91-7063-940-1 (ISBN)
Projects
iRiSk- Insatser och Risk/skyddsbedömningar för våldsutsatta barn
Funder
Swedish National Board of Health and Welfare, RU10
Available from: 2018-05-16 Created: 2018-05-16 Last updated: 2019-07-03Bibliographically approved
Almqvist, K., Källström, Å., Appell, P. & Anderzen-Carlsson, A. (2018). Mothers’ opinions on being asked about exposure to intimate partner violence in child healthcare centres in Sweden. Journal of Child Health Care, 22(2), 228-237
Open this publication in new window or tab >>Mothers’ opinions on being asked about exposure to intimate partner violence in child healthcare centres in Sweden
2018 (English)In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 22, no 2, p. 228-237Article in journal (Refereed) Published
Abstract [en]

Intimate partner violence (IPV) constitutes a hidden health risk for exposed mothers and children. In Sweden, screening for IPV in healthcare has only been routine during pregnancy, despite an increase in IPV following childbirth. The arguments against routine questions postpartum have concerned a lack of evidence of beneficial effects as well as fear of stigmatizing women or placing abused women at further risk. Increased understanding of women’s attitudes to routine questions may allay these fears. In this study, 198 mothers in 12 child healthcare centres (CHCs) filled in a short questionnaire about their exposure and received information on IPV at a regular baby check-up visit. The mothers’ lifetime prevalence of exposure to IPV was 16%. One hundred and twenty-eight mothers participated in a telephone interview, giving their opinion on the screening experience. The intervention was well-received by most of the mothers who reported that questions and information on IPV are essential for parents, considering the health risks for children, and that the CHC is a natural arena for this. Necessary prerequisites were that questioning be routine to avoid stigmatizing and be offered in privacy without the partner being present.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Child healthcare, domestic violence, intimate partner violence, routine screening, article, child, female, health hazard, human, human experiment, infant, major clinical study, mother, partner violence, prevalence, privacy, questionnaire, Sweden, telephone interview
National Category
Health Sciences
Research subject
Public Health Science
Identifiers
urn:nbn:se:kau:diva-68063 (URN)10.1177/1367493517753081 (DOI)000434024600006 ()2-s2.0-85047936118 (Scopus ID)
Available from: 2018-06-26 Created: 2018-06-26 Last updated: 2018-06-26Bibliographically approved
Pernebo, K., Fridell, M. & Almqvist, K. (2018). Outcomes of psychotherapeutic and psychoeducative group interventions for children exposed to intimate partner violence. International Journal of Child Abuse & Neglect, 79, 213-223
Open this publication in new window or tab >>Outcomes of psychotherapeutic and psychoeducative group interventions for children exposed to intimate partner violence
2018 (English)In: International Journal of Child Abuse & Neglect, ISSN 0145-2134, E-ISSN 1873-7757, Vol. 79, p. 213-223Article in journal (Refereed) Published
Abstract [en]

Witnessing violence toward a caregiver during childhood is associated with negative impact on children's health and development, and there is a need for effective interventions for children exposed to intimate partner violence in clinical as well as in community settings. The current effectiveness study investigated symptom reduction after participation in two established group interventions (one community-based psychoeducative intervention; one psychotherapeutic treatment intervention) for children exposed to intimate partner violence and for their non-offending parent. The study included 50 children—24 girls and 26 boys—aged 4–13 years and their mothers. Child and maternal mental health problems and trauma symptoms were assessed pre- and post-treatment. The results indicate that although children showed benefits from both interventions, symptom reduction was larger in the psychotherapeutic intervention, and children with initially high levels of trauma symptoms benefited the most. Despite these improvements, a majority of the children's mothers still reported child trauma symptoms at clinical levels post-treatment. Both interventions substantially reduced maternal post-traumatic stress. The results indicate a need for routine follow-up of children's symptoms after interventions.

Place, publisher, year, edition, pages
Elsevier Ltd, 2018
Keywords
Child witness of intimate partner violence, Children, Domestic violence, IPV, Outcome research, Post traumatic stress, Treatment, adolescent, adult, Article, child, child abuse, clinical article, female, human, male, maternal stress, mental health, partner violence, posttraumatic stress disorder, psychoeducation, psychotherapy, psychotrauma, treatment outcome
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:kau:diva-66660 (URN)10.1016/j.chiabu.2018.02.014 (DOI)000436522200022 ()2-s2.0-85042369490 (Scopus ID)
Available from: 2018-03-13 Created: 2018-03-13 Last updated: 2018-09-05Bibliographically approved
Draxler, H., Hjärthag, F. & Almqvist, K. (2018). Replicability of effect when transferring a supportive programme for parents exposed to intimate partner violence and their children from the US to Sweden. Child Care in Practice, 1-17
Open this publication in new window or tab >>Replicability of effect when transferring a supportive programme for parents exposed to intimate partner violence and their children from the US to Sweden
2018 (English)In: Child Care in Practice, ISSN 1357-5279, E-ISSN 1476-489X, p. 1-17Article in journal (Refereed) Epub ahead of print
Abstract [en]

Transferring an evidence-based parenting programme for parents exposed to intimate partner violence (IPV) and their children with emotional and behavioural problems reveals the extent to which cultural and social aspects can interfere with the programme’s effectiveness. Feasibility studies are of value in such circumstances, and the aim of the present feasibility study was to explore, on a small scale and in its natural context, whether the effects of the parenting programme, Project Support, were replicable when transferred to another country. In this study, the programme, which was originally designed for parents exposed to IPV and their children who had developed psychological symptoms in the United States, was evaluated in an equivalent population receiving Swedish social services. Parents (n = 35) self-assessed their parenting capacity and their children’s (n = 35) psychological symptoms. The results indicate that the parents improved their parenting capacity, and feelings of helplessness and fear regarding parenting their children decreased. Those feelings were also associated with the children’s psychological symptoms. The promising results are similar to the findings of previous research from the US, and further implementation and evaluation of Project Support in Sweden are indicated. (PsycINFO Database Record (c) 2018 APA, all rights reserved) (Source: journal abstract)

Place, publisher, year, edition, pages
Routledge, 2018
Keywords
Feasibility study, parenting, domestic violence, social work, children’s psychological symptoms
National Category
Psychology (excluding Applied Psychology)
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-70309 (URN)10.1080/13575279.2018.1463968 (DOI)
Available from: 2018-11-27 Created: 2018-11-27 Last updated: 2019-06-07Bibliographically approved
Pernebo, K. & Almqvist, K. (2017). Young Children Exposed to Intimate Partner Violence Describe their Abused Parent: A Qualitative Study. Journal of family Violence, 32(2), 169-178
Open this publication in new window or tab >>Young Children Exposed to Intimate Partner Violence Describe their Abused Parent: A Qualitative Study
2017 (English)In: Journal of family Violence, ISSN 0885-7482, E-ISSN 1573-2851, Vol. 32, no 2, p. 169-178Article in journal (Refereed) Published
Abstract [en]

The negative impact of intimate partner violence (IPV) begins early in the child's relationship with a caregiver. Children's relationships with, and internal working models of, abused parents have rarely been documented. The aim of this study was to collect and interpret young children's accounts of their abused parent. Interviews were conducted with 17 children aged 4 to 12 years who had witnessed IPV. Thematic analysis identified three main themes and seven sub-themes: "Coherent accounts of the parent" (sub-themes of "general benevolence", "provision of support, protection, and nurture", and "parental distress"); "Deficient accounts of the parent" ("vague accounts" and "disorganized narrations"); and "The parent as a trauma trigger" ("avoidance" and "breakthrough of intrusive memories and thoughts"). The results indicate these children may hold integrated, deficient, or blocked internal representations of an abused parent, and they illustrate the benefit of including young children as informants in research.

Place, publisher, year, edition, pages
Springer, 2017
Keywords
Child, Children witnessing intimate partner violence, Domestic violence, Qualitative research, Children's accounts
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-63883 (URN)10.1007/s10896-016-9856-5 (DOI)000393040500004 ()28163366 (PubMedID)
Available from: 2017-09-21 Created: 2017-09-21 Last updated: 2019-06-17Bibliographically approved
Bäccman, C., Hjärthag, F. & Almqvist, K. (2016). Improved resiliency and well-being among military personnel in a Swedish Naval Force after a counter-piracy operation off the coast of Somalia. Scandinavian Journal of Psychology, 57(4), 350-358
Open this publication in new window or tab >>Improved resiliency and well-being among military personnel in a Swedish Naval Force after a counter-piracy operation off the coast of Somalia
2016 (English)In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 57, no 4, p. 350-358Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to explore: (1) how the psychological health of the members of the first European Union Naval Force (ME01) was affected by international deployment off the coast of Somalia; and (2) if and how organizational and personal factors (e.g., type of personnel category, previous experiences, and resilience) affected their psychological health and well-being post-deployment. The study had an exploratory longitudinal design, where the participants were assessed both before and after deployment (i.e., T1 and T2). The participants (n=129, 120 men, 9 women) were equally distributed between officers (n=68; 64 men, 4 women) and sailors (n=61; 56 men, 5 women). The members' average age was 31years, ranging from 20 to 61. For the majority (78%) ME01 was their first international deployment and officers were, in general, more experienced than sailors. The overall results showed that the members' reported a positive experience with improved resilience and well-being (e.g., sense of coherence). However, the result also showed that type of personnel category (i.e., officer or sailor) affected their psychological health. Why and how these differences among military personnel arise is discussed, but deserves further attention.

Keywords
Military personnel, international deployment, naval, resilience, psychological health, well-being
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:kau:diva-44662 (URN)10.1111/sjop.12299 (DOI)000379940000011 ()27253612 (PubMedID)
Available from: 2016-08-12 Created: 2016-08-12 Last updated: 2017-11-28Bibliographically approved
Almqvist, K. & Draxler, H. (2016). Project Support: En genomförbarhetsstudie av ett individuellt föräldrastöd i socialtjänsten för våldsutsatta föräldrar. Karlstad: Karlstads universitet
Open this publication in new window or tab >>Project Support: En genomförbarhetsstudie av ett individuellt föräldrastöd i socialtjänsten för våldsutsatta föräldrar
2016 (Swedish)Report (Other academic)
Abstract [sv]

Genomförbarheten av Project Support (PS), ett individuellt föräldrastöd för våldsutsatta mammor utvecklat i USA, utvärderas inom ramen för svensk socialtjänst i denna studie. Sammanlagt trettio behandlare har utbildats i metoden, som anpassats till svenska förhållanden i samarbete med upphovsmännen. Tjugonio familjer hade inkluderats i behandling vid sttudiens avslut. Såväl behandlare som mammor uppskattade metoden och bedömde att den var en lämplig insats som förbättrade föräldrarnas samspel med sina barn. Mammornas självskattade föräldraförmåga förbättrades signifikant, och barnens symtomnivåer sänktes. Vissa svårigheter för implementering identifierades, dels metodspecifika, dels relaterade till omständigheter i socialtjänsten.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2016. p. 28
Series
Karlstad University Studies, ISSN 1403-8099 ; 2015:26
Keywords
Intimate Partner Violence, interventions, children, mental health, social work, våld i nära relationer, insatser, barns psykiska hälsa, socialtjänsten
National Category
Applied Psychology
Research subject
Psychology with an emphasis on medical psychology
Identifiers
urn:nbn:se:kau:diva-41256 (URN)978-91-7063-704-9 (ISBN)
Projects
Insatser för våldsutsatta barn
Funder
Swedish National Board of Health and Welfare, 4394
Available from: 2016-04-08 Created: 2016-04-08 Last updated: 2016-05-10Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-3560-0394

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