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Sengoelge, M., Johnson-Singh, C. M., Mittendorfer-Rutz, E., Vaez, M. & Saboonchi, F. (2019). Identifying subgroups of refugees from Syria resettled in Sweden based on multiple trauma exposures: A latent class analysis of trauma history and mental health outcomes.. Journal of Psychosomatic Research, 125, Article ID 109814.
Open this publication in new window or tab >>Identifying subgroups of refugees from Syria resettled in Sweden based on multiple trauma exposures: A latent class analysis of trauma history and mental health outcomes.
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2019 (English)In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 125, article id 109814Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Many refugees have been subjected to pre-migratory trauma. Evidence is needed to address the heterogeneity within refugee populations in regard to patterns of multiple trauma exposures. This study identified subgroups within a refugee population displaying different profiles of multiple trauma exposures and assessed sociodemographic predictors and differences in mental health symptom severity across these classes.

METHODS: Study population consisted of 1215 refugees from Syria resettled in Sweden. Latent class analysis 3-step method for modelling predictors and outcomes and a class-specific weighted multigroup approach were used to identify classes of refugees using self-reported data on violent and non-violent trauma exposures, sociodemographic variables and symptom severity scores for depression, anxiety and PTSD.

RESULTS: Three classes were identified: class 1 'multiple violent and non-violent trauma' (39.3%, n = 546); class 2 'witnessing violence and multiple non-violent trauma' (40.8%, n = 569); and class 3 'low multiple non-violent trauma' (20.1%, n = 281). Trauma exposure and gender significantly predicted class membership. Male gender and highest severity of mental ill health defined class 1. Female gender predicted higher mental ill health within classes 1 and 2. Across all three classes living with a partner was associated with lower severity of mental ill health regardless of trauma exposure classes.

CONCLUSIONS: There are distinct patterns within refugee populations concerning exposure to multiple trauma. Violence is a primary marker for higher likelihood of multiple trauma exposures and severity of mental health. Gender predisposes individuals to trauma exposure and its outcomes differentially.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Anxiety, Depression, Latent class analysis, Multiple trauma, Post-traumatic stress disorder (PTSD), Refugees
National Category
Occupational Health and Environmental Health
Identifiers
urn:nbn:se:rkh:diva-3035 (URN)10.1016/j.jpsychores.2019.109814 (DOI)31470254 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-07194
Available from: 2019-09-06 Created: 2019-09-06 Last updated: 2019-09-06Bibliographically approved
Nymark, C., Henriksson, P., Mattiasson, A.-C., Saboonchi, F. & Kiessling, A. (2019). Inability to act was associated with an extended delay prior to care-seeking, in patients with an acute myocardial infarction. European Journal of Cardiovascular Nursing, 18(6), 512-520
Open this publication in new window or tab >>Inability to act was associated with an extended delay prior to care-seeking, in patients with an acute myocardial infarction
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2019 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 18, no 6, p. 512-520Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The out-of-hospital mortality in patients with acute myocardial infarction remains unchanged in contrast to a decrease in inhospital mortality. Interventions aiming to shorten patient delay have been largely unsuccessful. A deeper understanding is apparently needed on patients' appraisal prior to care-seeking.

AIM: To investigate whether appraisal processes influence patient delay, and if the questionnaire 'Patients' appraisal, emotions and action tendencies preceding care seeking in acute myocardial infarction' (PA-AMI) could discriminate between patients with prolonged care-seeking and those with a short delay.

METHODS: A cross-sectional study including 326 acute myocardial infarction patients filling out the validated questionnaire PA-AMI. The impact of subscales on delay was analysed by projection to latent structures regression. Discrimination opportunities between patients with short and long delays were analysed by projection to latent structures discriminant analysis.

RESULTS: The subscales 'perceived inability to act' and 'symptom appraisal' had a major impact on patient delay ( P<0.0001). 'Perceived inability to act' had its main influence in patients with a delay exceeding 12 hours, and 'symptom appraisal' had its main influence in patients with a delay shorter than one hour.

CONCLUSION: Appraisal processes influence patient delay. Acute myocardial infarction patients with a prolonged delay were, besides a low perceived symptom severity and urgency to seek medical care, characterised by a perceived loss of control and ability to act. Therefore, future interventions aimed at decreasing delay should pay attention to appraisal processes, and perceived inability to act may be a sign of a health threat and therefore a signal to seek medical care.

Keywords
Acute myocardial infarction, PLS regression analysis, appraisal process, patient delay, questionnaire
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-2839 (URN)10.1177/1474515119844654 (DOI)31132880 (PubMedID)
Funder
Swedish Heart Lung FoundationStockholm County Council
Available from: 2019-06-12 Created: 2019-06-12 Last updated: 2019-08-14Bibliographically approved
Helgesson, M., Wang, M., Niederkrotenthaler, T., Saboonchi, F. & Mittendorfer-Rutz, E. (2019). Labour market marginalisation among refugees from different countries of birth: a prospective cohort study on refugees to Sweden. Journal of Epidemiology and Community Health, 73(5), 407-415
Open this publication in new window or tab >>Labour market marginalisation among refugees from different countries of birth: a prospective cohort study on refugees to Sweden
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2019 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 73, no 5, p. 407-415Article in journal (Refereed) Published
Abstract [en]

Background: The aim was to elucidate if the risk of labour market marginalisation (LMM), measured as long-term unemployment, long-term sickness absence, disability pension and a combined measure of these three measures, differed between refugees and non-refugee migrants with different regions of birth compared with native Swedes.

Methods: All non-pensioned individuals aged 19-60 years who were resident in Sweden on 31 December 2009 were included (n= 4 441 813, whereof 216 930 refugees). HRs with 95% CIs were computed by Cox regression models with competing risks and time-dependent covariates with a follow-up period of 2010-2013.

Results: Refugees had in general a doubled risk (HR: 2.0, 95% CI 1.9 to 2.0) and non-refugee migrants had 70% increased risk (HR: 1.7, 95% CI 1.7 to 1.7) of the combined measure of LMM compared with native Swedes. Refugees from Somalia (HR: 2.7, 95% CI 2.6 to 2.8) and Syria (HR: 2.5, 95% CI 2.5 to 2.6) had especially high risk estimates of LMM, mostly due to high risk estimates of long-term unemployment (HR: 3.4, 95% CI 3.3 to 3.5 and HR: 3.2, 95% CI 3.1 to 3.2). African (HR: 0.7, 95% CI 0.6 to 0.7) and Asian (HR: 1.0, 95% CI 1.0 to 1.1) refugees had relatively low risk estimates of long-term sickness absence compared with other refugee groups. Refugees from Europe had the highest risk estimates of disability pension (HR: 1.9, 95% CI 1.8 to 2.0) compared with native Swedes.

Conclusion: Refugees had in general a higher risk of all measures of LMM compared with native Swedes. There were, however, large differences in risk estimates of LMM between subgroups of refugees and with regard to type of LMM. Actions addressing differences between subgroups of refugees is therefore crucial in order to ensure that refugees can obtain as well as retain a position on the labour market.

Place, publisher, year, edition, pages
BioMed Central, 2019
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:rkh:diva-3007 (URN)10.1136/jech-2018-211177 (DOI)30755462 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-07194
Available from: 2019-08-06 Created: 2019-08-06 Last updated: 2019-08-06Bibliographically approved
Vikdahl, L., Gunnarsson, D., Larsen, J., Ståhle, G. & Saboonchi, F. (2018). Mångfald och hälsa: En kartläggning av vilka kunskapsbehov som finns hos några samhällsaktörer i Södertörnregionen gällande mångfald och hälsa, med fokus på nyanländas etablering.. Huddinge: Flemingsberg Science
Open this publication in new window or tab >>Mångfald och hälsa: En kartläggning av vilka kunskapsbehov som finns hos några samhällsaktörer i Södertörnregionen gällande mångfald och hälsa, med fokus på nyanländas etablering.
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2018 (Swedish)Report (Other academic)
Place, publisher, year, edition, pages
Huddinge: Flemingsberg Science, 2018. p. 34
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:rkh:diva-2738 (URN)
Available from: 2019-01-08 Created: 2019-01-08 Last updated: 2019-01-09Bibliographically approved
Nordhall, O., Knez, I. & Saboonchi, F. (2018). Predicting general mental health and exhaustion: the role of emotion and cognition components of personal and collective work-identity.. Heliyon, 4(8), Article ID e00735.
Open this publication in new window or tab >>Predicting general mental health and exhaustion: the role of emotion and cognition components of personal and collective work-identity.
2018 (English)In: Heliyon, ISSN 2405-8440, Vol. 4, no 8, article id e00735Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to investigate relationships between emotion and cognition components of personal and collective work-identity and self-reported general mental health and exhaustion, in Swedish teachers (N = 768). In line with our predictions, we showed that the emotion component of personal work-identity and the cognition component of collective work-identity associated positively with general mental health and negatively with exhaustion. The reverse result was found, however, for the cognition component of personal work-identity and emotion component of collective work-identity. In general, all this indicates that person-work bonding might, to some degree, account for general mental health and exhaustion in employees. In particular, the findings suggest that general mental health and exhaustion may vary symmetrically across the: (1) Type of person-work bonding (personal vs. collective work-identity); and (2) Type of psychological component (emotion vs. cognition) involved in personal- and collective work-identity.

Keywords
Psychology
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-2614 (URN)10.1016/j.heliyon.2018.e00735 (DOI)30140768 (PubMedID)
Available from: 2018-08-30 Created: 2018-08-30 Last updated: 2018-08-31Bibliographically approved
Okenwa-Emegwa, L., Saboonchi, F. & Tinghög, P. (2018). Prevalence and predictors of violence among Syrian refugee women resettled in Sweden. Paper presented at 11th European Public Health Conference Winds of change: towards new ways of improving public health in Europe Ljubljana, Slovenia 28 November–1 December 2018. European Journal of Public Health, 28(Suppl. 4), 156
Open this publication in new window or tab >>Prevalence and predictors of violence among Syrian refugee women resettled in Sweden
2018 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Suppl. 4, p. 156-Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background Refugee women are at more risk of a continuum of violence, pre, during and post flight. After resettlement, increased family conflicts are likely, due to shifts in gender roles and changing family structures. Prevalence estimates, however, remain scarce especially for Syrian refugee women in Europe. Given that exposure to violence is a substantial risk factor for ill health and poor adaptation, this study aims to estimate the prevalence of violence in different phases of flight and associated sociodemographic factors. Methods The study is based on a random sample of 452 Syrian refugee women resettled in Sweden. Exposure to violence was operationalised as having been a victim of torture, physical or sexual violence, pre and during flight; witnessing violence was operationalised as experiencing war at close quarters, witnessing physical violence, or forced separation from loved ones, pre and during flight; family conflicts was operationalised as experiencing distressing conflicts in the family since resettlement. Descriptive analysis were conducted to estimate prevalence and logistic regression to assess associations. Weighted data produced socio-demographically representative estimates. Robust standard errors were used to obtain 95% confidence intervals for all estimates. Results About 25.1% (95% 20.9 – 29.4) of the women were exposed to violence preflight, 7.8% (95% 5.2 – 10.4) were victims during flight. Up to 93.3% (95% 90.7 – 95.9) witnessed violence preflight, 67.2% (95% 62.6 – 71.8) during flight. About 34.2% (95% 29.7 – 38.7) are experiencing distressing family conflicts.Logistic regressions showed no significant difference after controlling for age, education and marital status. Conclusions The magnitude of violence and ongoing family conflicts calls for a closer look at the plight of refugee women.Violence is widespread and not specific to any sociodemographic group, an important finding for healthcare and public health workforce to take note of. 

National Category
Health Sciences
Identifiers
urn:nbn:se:rkh:diva-2734 (URN)10.1093/eurpub/cky213.457 (DOI)
Conference
11th European Public Health Conference Winds of change: towards new ways of improving public health in Europe Ljubljana, Slovenia 28 November–1 December 2018
Available from: 2018-11-29 Created: 2018-11-29 Last updated: 2019-04-09Bibliographically approved
Petersson, L.-M., Vaez, M., Nilsson, M. I., Saboonchi, F., Alexanderson, K., Olsson, M. & Wennman-Larsen, A. (2018). Sickness absence following breast cancer surgery: a two-year follow-up cohort study. Scandinavian Journal of Caring Sciences, 32(2), 715-724
Open this publication in new window or tab >>Sickness absence following breast cancer surgery: a two-year follow-up cohort study
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2018 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 2, p. 715-724Article in journal (Refereed) Published
Abstract [en]

RATIONALE AND AIM: Most women of working ages with limited breast cancer (BC) have returned to work within the first year after diagnosis. However, little is known about what is happening during this year regarding sickness absence and return to work. Also, the knowledge is very limited about the occurrence of part-time sickness absence after BC diagnosis. Therefore, the aim of this study was to describe occurrence, extent and length of SA during a two-year follow-up after BC surgery and to analyse the association between being SA and type of cancer treatment.

METHODS: In this prospective cohort study, 497 women responded to questionnaires about different aspects of sickness absence at six occasions during two years after primary BC surgery (at baseline and after 4, 8, 12, 18 and 24 months). Treatment information was obtained from the National breast cancer register. Multinomial logistic regression was used to calculate odds ratios (OR) for likelihood of being sickness absent more than once.

RESULTS: Two-thirds of the women were sickness absent at baseline; this proportion decreased, especially during the first eight months. At 24 months, 13% were sickness absent. Of all women, 27% never reported sickness absence and 14% were sickness absent at most of the six survey times. At eight months, many had shifted from full- to part-time sickness absence. Women with chemotherapy and/or advanced BC surgery had higher ORs for being sickness absent at most of the follow-ups.

CONCLUSIONS: Most women returned to work within the first eight months after BC surgery and of those sickness absent after that, most had been part-time sickness absent. Thus, it is important to differentiate between part- and full-time sickness absence in future studies. Special attention should be paid to the impact of chemotherapy and type of surgery on the likelihood of being sickness absent.

Keywords
breast cancer, insurance medicine, sick leave, work
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:rkh:diva-2459 (URN)10.1111/scs.12502 (DOI)29048131 (PubMedID)
Funder
Swedish Cancer SocietySwedish Research CouncilForte, Swedish Research Council for Health, Working Life and WelfareThe Breast Cancer FoundationThe Cancer Research Funds of Radiumhemmet
Available from: 2017-10-27 Created: 2017-10-27 Last updated: 2018-07-12Bibliographically approved
Manhica, H., Niemi, M., Gunnarsson, D., Ståhle, G., Larsson, S. & Saboonchi, F. (2018). Social participation, mental health in refugees and asylum seekers: A scoping review. European Journal of Public Health, 28(Suppl. 4), 482-482
Open this publication in new window or tab >>Social participation, mental health in refugees and asylum seekers: A scoping review
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2018 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, no Suppl. 4, p. 482-482Article in journal, Meeting abstract (Other academic) Published
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:rkh:diva-2798 (URN)10.1093/eurpub/cky218.213 (DOI)
Available from: 2019-04-09 Created: 2019-04-09 Last updated: 2019-04-09Bibliographically approved
Helgesson, M., Tinghög, P., Wang, M., Rahman, S., Saboonchi, F. & Mittendorfer-Rutz, E. (2018). Trajectories of work disability and unemployment among young adults with common mental disorders. BMC Public Health, 18, Article ID 1228.
Open this publication in new window or tab >>Trajectories of work disability and unemployment among young adults with common mental disorders
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2018 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 18, article id 1228Article in journal (Refereed) Published
Abstract [en]

BackgroundLabour-market marginalisation (LMM) and common mental disorders (CMDs) are serious societal problems. The aims were to describe trajectories of LMM (both work disability and unemployment) among young adults with and without CMDs, and to elucidate the characteristics associated with these trajectories.MethodsThe study was based on Swedish registers and consisted of all individuals 19-30years with an incident diagnosis of a CMD in year 2007 (n=7245), and a matched comparison group of individuals without mental disorders during the years 2004-07 (n=7245). Group-based trajectory models were used to describe patterns of LMM both before, and after the incident diagnosis of a CMD. Multinomial logistic regressions investigated the associations between sociodemographic and medical covariates and the identified trajectories.ResultsTwenty-six percent (n=1859) of young adults with CMDs followed trajectories of increasing or constant high levels of work disability, and 32 % (n=2302) followed trajectories of increasing or constant high unemployment. In the comparison group, just 9 % (n=665) followed increasing or constant high levels of work disability and 21 % (n=1528) followed trajectories of increasing or constant high levels of unemployment. A lower share of young adults with CMDs followed trajectories of constant low levels of work disability (n=4546, 63%) or unemployment (n=2745, 38%), compared to the level of constant low work disability (n=6158, 85%) and unemployment (n=3385, 50%) in the comparison group. Remaining trajectories were fluctuating or decreasing. Around 50% of young adults with CMDs had persistent levels of LMM at the end of follow-up. The multinomial logistic regression revealed that educational level and comorbid mental disorders discriminated trajectories of work disability, while educational level, living area and age determined differences in trajectories of unemployment (R-difference(2)=0.02-0.05, p<0.001).ConclusionsA large share, nearly 50%, of young adults with CMDs, substantially higher than in the comparison group of individuals without mental disorders, display increasing or high persistent levels of either work disability or unemployment throughout the follow-up period. Low educational level, comorbidity with other mental disorders and living in rural areas were factors that increased the probability for LMM.

Keywords
Sick leave, Disability pension, Unemployment, Common mental disorders, Labour market marginalisation, Education
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:rkh:diva-2733 (URN)10.1186/s12889-018-6141-y (DOI)30400785 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2015–00742
Available from: 2018-11-22 Created: 2018-11-22 Last updated: 2018-11-22Bibliographically approved
Okenwa-Emegwa, L., Paillard-Borg, S., Tinghög, P., Saboonchi, F. & von Strauss, E. (2017). A global workspace is the emerging reality for future public health workforce. Socialmedicinsk Tidskrift, 94(3), 132-140
Open this publication in new window or tab >>A global workspace is the emerging reality for future public health workforce
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2017 (English)In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 94, no 3, p. 132-140Article in journal (Refereed) Published
Abstract [en]

There is an urgent need to train public health professionals at undergraduate level who can face global challenges that are due to longstanding conflicts, increasing number of displaced people, natural disasters, and growing inequalities between and within countries. Future public health professionals will lead activities ranging from national and international community planning, strategic work geared towards integration of migrants and crisis management of refugees, and humanitarian services. Consequently, the need for public health professionals with deep and wide theoretical and practical competencies in global contexts has become most relevant. In response to this need, The Swedish Red Cross University College has created such a programme leading to a Bachelor degree in Public Health Science, specialization Global Health.

Keywords
global health, global health challenges, public health sciences, public health professionals, undergraduate education
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:rkh:diva-2448 (URN)
Available from: 2017-09-09 Created: 2017-09-09 Last updated: 2017-09-11Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-5376-5048

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