Important aspects of conducting an interdisciplinary public preventive oral health project for children in areas with low socioeconomic status: staff perspective

Abstract Background To achieve good and equal oral health in children, interdisciplinary preventive oral health actions, directed toward disadvantaged areas, can be an important means. Staff play a crucial role in the implementation of these actions. The aim of the present study was to analyze circumstances of importance for conducting an interdisciplinary public preventive oral health project for children, directed toward parents in areas with low socioeconomic status from the interdisciplinary perspective of the involved staff. Method The present study consisted of a qualitative content analysis with an inductive approach, based on interviews with interdisciplinary staff who had participated in a public preventive oral health project directed toward parents in areas with low socioeconomic status. The interviews were analyzed using text-driven analysis. Results The main category concerned the staff members’ prerequisites and understanding necessary to perform their tasks in interdisciplinary public preventive oral health project. To have the right prerequisites and understanding regarding the oral health project enabled staff to be committed, able and willing to perform in it. Important aspects of this are to have knowledge, motivation and to experience a supportive professional context, to have good leadership and for certain resources to fulfilled. A crucial aspect was to reach the targeted mothers. Conclusions For interdisciplinary cooperation in preventive oral health care to be achieved, it is essential for the involved disciplines and professions to embrace a common view on the project’s aim, their duties, and oral health, from the leadership to the individual level. Staff require competent leadership but also allocated time and adapted method support to be successful in this context. When allocating preventive health actions directed at low SES areas, it is important to acknowledge the risk of stigmatization and for staff to understand that families might be facing social challenges that prevent them from taking part in health-promoting actions. An important conclusion is that to be able to reach people, it is important for both those who design preventive programs for oral health and the staff who administer them to have sufficient knowledge about the target group. </jats:sec

Support/services and family carers of persons with stroke impairment: Perceived importance and services received

Objective: To examine what family carers of persons with stroke impairment perceive as important support and service quality characteristics in relation to their experienced strain/burden, and to explore to what extent family carers receive support/services perceived as important. Design: Data from a cross-sectional study. Subjects: A sample of 183 family carers in Sweden, 64 experiencing lower and 119 experiencing higher strain/burden, a subsample of the EUROFAMCARE project. Methods: Carers were interviewed using a structured questionnaire. Results: There are few differences between carers experiencing high and low strain/burden in what they perceive and receive in terms of important support and service quality characteristics. Information, relief, and counselling support/services are highly valued. It is also important that services improve quality of life, and have good process qualities regarding interaction with staff and individualization. Most services regarded as important are received by less than 60% of carers. Conclusion: The variation is rather high on an individual level in terms of what carers regard as important, indicating that factors other than negative impact may influence their perceptions of support/service and service quality. Thus, it is important to know carers perceptions in order to individualize support/service, and thus make it more available and efficient.</p

User involvement in designing a web-based support system for young carers – inspiring views and systemic barriers

The studies in this dissertation have their origin in the research project PS Young Support. This project aimed to develop and evaluate a web-based support system (WBSS) for young people living close to someone with mental illness. To make this support relevant, and to achieve legitimacy and trustworthiness it was found important to cooperate with prospective users in developing it through a participatory design (PD) process. The dissertation follows two lines of investigation. One of these relates to how PD can inspire new views on design, while the other is about barriers to involvement of users. Specifically, inspiring views aims at how a PD process with prospective users as co-designers has influenced the way we think about WBSSs. Moving on from the common idea of a WBSS as a stand-alone intervention, Studies I and II show that WBSSs can be used as a tool to reach real-life support. Earlier research suggests that online support is rarely the preferred support; the present research show that young carers viewed it as a starting point for reaching real-life contacts and real- life support. Furthermore, young people with poor mental health are more prone to seek support online compared with those with less poor mental health. Hence, a WBSS could serve as a means to capture the former group and offer them online support. At the same time it could serve as a tool for reaching real-life support and external services. In this way the WBSS could offer a help path to individuals in need of support. Study IV investigates meta design, i.e. how users have really used the WBSS and the conditions for redesign. The development WBSS and its implemented version are compared with respect to their intended use (thing design) and how they really were used (use design). The context of use was found to be critical, since data collected in an experimental setting may be misleading and not reflect real use. Consequently, natural settings are recommended for user feedback. The second line of investigation in this dissertation concerns systemic barriers including barriers to user influence. It is not common in PD to focus on the designers. However, Study II and III reveal two types of barriers, both of which are connected to the designers. They are “systemic” barriers as they are a part of the setting that constitutes design. They cannot really be avoided, just handled. The first barrier has to do with the fact that users and designers do not regularly share the same social conditions, and consequently that they have different assumptions, implying that they may have difficulties to understand each other. Assumptions of shared views and the fact that understanding is a process that takes time may increase the effect of this foundational difference. Study II reports crucial differences in the views of what the WBSS should support. The second barrier concerns the impact of deadlines on designers’ attitudes to users’ contributions. Study III reports that halfway through the design process, designers reorganized their work and put more effort into the act of producing an artefact. Along with this shift, designers’ preferred type of knowledge seemed to change, from knowledge based on user experience to expert knowledge

Development of an internet-based support and coaching model for adolescents and young adults with ADHD and autism spectrum disorders: a pilot study

The aims of this paper were to develop an internet-based support and coaching model for young people with autism spectrum disorder (ASD) and/or attention-deficit/hyperactivity disorder (ADHD), and to validate the model. A user-centred design was applied to develop a model for internet-based support and coaching, where individuals received 8-week support via internet (chat). The model was validated by 10 individuals, 15-26 years of age, with ASD and/or ADHD. Self-report questionnaires [Sense of Coherence (SOC), the Rosenberg Self Esteem Scale, the Manchester Short Assessment of Quality of Life, Montgomery sberg Depression Rating Scale, and the Hospital Anxiety and Depression Scale] were distributed before and after intervention. A structured interview regarding the quality of the model, the Patient perspective of Care and Rehabilitation process (POCR), was used after the intervention. The validation showed significant improvement of SOC, self-esteem and subjective Quality of Life at follow-up and the majority perceived high fulfilment/importance on the POCR. In conclusion, The model can be an important complement to other interventions for young people with ASD and/or ADHD.</p

Daily life for young adults who care for a person with mental illness: a qualitative study

Accessible summary The burden of caring for a person with mental illness has been transferred to families and close friends. Daily life for young informal carers is unpredictable and they need to stay alert and prepared for events beyond their control. Young informal carers are concerned young adults who support a family member or friend unconditionally. Supporting a friend is related to as a great a sense of individual responsibility as supporting a family member. Abstract This study describes the daily life and management strategies of young informal carers of family members or friends with mental illness. Twelve young adults (three men and nine women; 1625 years old) in Sweden were voluntarily recruited between February and May 2008. Data collected through eight individual semi-structured interviews and one focus group interview were analysed using qualitative content analysis. The findings revealed nine subthemes that were further grouped into three main themes: showing concern, providing support and using management strategies. Participants lived in constant readiness for something unexpected to happen to the person they cared for, and their role in the relationship could change quickly from family member or friend to guardian or supervisor. Supporting a friend was considered as large a personal responsibility as supporting a family member. Their management strategies were based on individual capacities and their ability to step aside should the situation become too demanding. These young informal carers need support in caring for the mentally ill. As the internet becomes increasingly fundamental to daily life, support could be provided most effectively through person-centred web sites.</p

The EUROFAMCARE Common Assessment Tool (CAT): Item and scale development and description

The chapter describes the psychometric properties of the survey tool used in the European study Eurofamcar

The EUROFAMCARE Common Assessment Tool (CAT): Item and scale development and description

The chapter describes the survey tool used for the EUROFAMCARE study, including how it was derived, the scales that were included and their psychometric properties, and some descriptive analyse

Typology of caregiving situations in Europe: A cluster analysis approach

The chapter describes the development, by using cluster analysis, of a typology of caregiving situations in Europe on the basis of the main variables included in the Eurofamcare study. Both variables regarding the older person and variables regarding the caregiver were include

Typology of caregiving situations in Europe: A cluster analysis approach

It presents a description of the different caregiving situations at the European level, by examining the characteristics of both the caregiver and the cared for perso