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Ekstrand, P., Tegnestedt, C., Schuster, M., Eriksson, H., Hägg Martinell, A. & Larsen, J. (2023). The meaning of health among newly arrived immigrants: A qualitative study from stakeholders’ perspectives. Nordic journal of nursing research, 43(1)
Open this publication in new window or tab >>The meaning of health among newly arrived immigrants: A qualitative study from stakeholders’ perspectives
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2023 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 43, no 1Article in journal (Refereed) Published
Abstract [en]

Good health is a prerequisite for individuals to function in everyday life. The same applies to newly arrived immigrants, where good health is crucial for successful establishment. The aim of this study was to describe stakeholders’ experiences of how newly arrived immigrants’ health affects their opportunities to establish themselves in society. The study had a qualitative design where open-ended questions were analysed following Braun and Clarke’s guidelines for conducting a qualitative thematic analysis. The results consist of three themes: Mental health problems, disabilities, and tormenting concerns about absent family members; A precarious life situation related to housing, education, and income; and Deficiencies in responding to health challenges in organisations and in society. Stakeholders face health problems among newly arrived immigrants that they do not have the right skills to deal with. We argue for the presence of nurses in organisations working with newly arrived immigrants, and that nurses’ competence is necessary to capture their needs.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
health, newly arrived immigrants, social participation, stakeholders, thematic qualitative analysis
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:rkh:diva-4253 (URN)10.1177/20571585221083525 (DOI)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-07194
Available from: 2022-04-29 Created: 2022-04-29 Last updated: 2024-01-09Bibliographically approved
Kumpula, E., Ekstrand, P. & Gustafsson, L.-K. (2022). Balancing security and care: Gender relations of nursing staff in forensic psychiatric care. Nursing Inquiry, 29(4), Article ID e12478.
Open this publication in new window or tab >>Balancing security and care: Gender relations of nursing staff in forensic psychiatric care
2022 (English)In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 29, no 4, article id e12478Article in journal (Refereed) Published
Abstract [en]

This study departs from the built-in tension of the dual goals of forensic psychiatric care in Sweden, which are to protect society as well as to care for patients. The majority of violence that takes place is perpetrated by men. Therefore, the views of nursing staff on violence as a gendered phenomenon have an impact on the care provision. There is a need for further knowledge of how norms of violence are intertwined with the construction of gender. The aim of this study was to use a gender perspective to demonstrate the views of nursing staff on security and care and the consequences for their relationships with patients. The study adopts an ethnographic approach, with data consisting of field notes from participatory observations and interviews with nursing staff at two maximum-security clinics. We show how the perceptions of nursing staff about gender relations are based on heteronormative thinking, which affects their practice. This implies that if gender is ignored in relation to the dual goals, there is a risk of perpetrating patterns of unequal conditions. Therefore, it is vital to make gender visible to counteract unequal conditions for nursing staff and address patients' individual care needs.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022
Keywords
ethnographic approach, forensic psychiatric care, gender, nursing staff, security, thematic analysis
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-4163 (URN)10.1111/nin.12478 (DOI)34843144 (PubMedID)
Available from: 2021-12-07 Created: 2021-12-07 Last updated: 2022-11-02Bibliographically approved
Schuster, M., Kraft, M., Hägg Martinell, A., Eriksson, H., Larsen, J. & Ekstrand, P. (2022). Challenges and Barriers to the Social Integration of Newly Arrived Immigrants in Sweden. Journal of Identity and Migration Studies, 16(1), 22-39
Open this publication in new window or tab >>Challenges and Barriers to the Social Integration of Newly Arrived Immigrants in Sweden
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2022 (English)In: Journal of Identity and Migration Studies, E-ISSN 1843-5610, Vol. 16, no 1, p. 22-39Article in journal (Refereed) Published
Abstract [en]

Sweden, like many other European countries, has received a large number of immigrants in the past few years. To tackle the challenge connected with this, a policy for integration including an establishment programme was adopted by the Swedish Government which speeded up the introduction of newly arrived immigrants into the labour market and social life. The implementation of the programme is performed by various stakeholders in the fields of the labour market, language education and non-governmental organisations.The aim of this study was to investigate challenges and barriers to integration from the perspective of stakeholders’ experiences of encounters with newly arrived immigrants. The study used open-ended data collected in a Delphi project targeting civil servants and volunteers working within the policy establishment programme, and a thematic analysis was conducted. The results indicate that focus on organisational structures, issues concerning resources and competence, and a more holistic approach to new arrivals’ existential situationare key areas to address to move towards successful integration.

Keywords
integration, core domains of integration, newly arrived immigrants, stakeholders, thematic analysis
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:rkh:diva-4271 (URN)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016–07194
Available from: 2022-05-28 Created: 2022-05-28 Last updated: 2023-10-04Bibliographically approved
Hägg Martinell, A., Eriksson, H., Ekstrand, P., Schuster, M. & Larsen, J. (2021). Social Participation as Reported by Civil Servants and Volunteers Working with Newly Arrived Immigrants in Sweden: Qualitative Data from a Delphi Study. Journal of Identity and Migration Studies, 15(1), 98-114
Open this publication in new window or tab >>Social Participation as Reported by Civil Servants and Volunteers Working with Newly Arrived Immigrants in Sweden: Qualitative Data from a Delphi Study
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2021 (English)In: Journal of Identity and Migration Studies, E-ISSN 1843-5610, Vol. 15, no 1, p. 98-114Article in journal (Refereed) Published
Abstract [en]

Primary health prevention regarding social participation for newly arrivedimmigrants is needed to address challenges when responding to the needs of suchimmigrants in their new and vulnerable situation. The aim of this study was to describe socialparticipation as reported by civil servants and volunteers working with newly arrivedimmigrants in Sweden. Open-ended data collected in a Delphi project targeting civil servantsand volunteers working within the policy establishment programme was used. Qualitativecontent analysis was conducted. The findings show that several interacting factors contributeto resources that create perquisites for “going native in the community” and “being part ofeveryday life” as points of perquisites for how civil servants and volunteers elaborate onsocial participation for newly arrived immigrants. A focus on the “here and now” and avoidingmeasures that “put life on hold” are two points of aspects that generate possibilities forpromoting social participation in health services.

Place, publisher, year, edition, pages
Oradea: Research Centre on Identity and Migration Issues, University of Oradea, Romania, 2021
Keywords
Health promotion, Health services, Newley arrived immigrants, Qualitativecontent analysis, Refugees, Social participation
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-4012 (URN)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2021-05-24 Created: 2021-05-24 Last updated: 2023-10-04Bibliographically approved
Kumpula, E., Gustafsson, L.-K. & Ekstrand, P. (2020). Illuminating the gendered nature of health-promoting activities among nursing staff in forensic psychiatric care. Nursing Inquiry, 27(2), Article ID e12332.
Open this publication in new window or tab >>Illuminating the gendered nature of health-promoting activities among nursing staff in forensic psychiatric care
2020 (English)In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 27, no 2, article id e12332Article in journal (Refereed) Published
Abstract [en]

When people in Sweden are sentenced and handed over to forensic psychiatric care(FPC), the authorities have overall responsibility for their health recovery. How nursing staff construct gender through their relations in this context affects their understanding of health promotion activities. The aim of this study was to illuminate, using a gender perspective, the understanding of nursing staff with respect to health promotion activities for patients. Four focus group interviews were conducted with nursing staff in two FPC clinics in Sweden. The study has a qualitative inductive design with an ethnographic approach. This study sheds new light on FPC in which its dual goals of protecting society and providing care are viewed from a gender perspective. When relationships within the nursing staff group and the nurse–patient relationship are justified by the goal of protecting society, gender becomes invisible.This might cause patients' individual conditions and needs for certain types of activitiesto go unnoticed. One of the implications of ignoring gender relations in nursingstaff health promotion activities is that it risks contributing to gender stereotypes which impact on the nurse–patient relationship and the quality of care.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
focus group interviews, forensic psychiatric care, gender, health-promoting activities, nursing staff
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-3109 (URN)10.1111/nin.12332 (DOI)31854012 (PubMedID)
Available from: 2019-12-19 Created: 2019-12-19 Last updated: 2021-09-09Bibliographically approved
Kumpula, E. & Ekstrand, P. (2019). Maktordningar som möjligheter eller hinder inom psykiatrisk vård (3ed.). In: Lena Wiklund Gustin (Ed.), Vårdande vid psykisk ohälsa: på avancerad nivå (pp. 135-151). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Maktordningar som möjligheter eller hinder inom psykiatrisk vård
2019 (Swedish)In: Vårdande vid psykisk ohälsa: på avancerad nivå / [ed] Lena Wiklund Gustin, Lund: Studentlitteratur AB, 2019, 3, p. 135-151Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2019 Edition: 3
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-3087 (URN)9789144123684 (ISBN)
Available from: 2019-11-22 Created: 2019-11-22 Last updated: 2019-12-13Bibliographically approved
Kumpula, E., Gustafsson, L.-K. & Ekstrand, P. (2019). Nursing Staff Talk: Resource or Obstacle for Forensic Psychiatric Patient Care?. Journal of Forensic Nursing, 15(1), 52-59
Open this publication in new window or tab >>Nursing Staff Talk: Resource or Obstacle for Forensic Psychiatric Patient Care?
2019 (English)In: Journal of Forensic Nursing, ISSN 1939-3938, E-ISSN 1556-3693, Vol. 15, no 1, p. 52-59Article in journal (Refereed) Published
Abstract [en]

Although forensic psychiatric care is located at the intersection of health care and the Swedish legal system, nursing research has not yet evaluated how language is context bound or its consequences for understanding patient care. The aim of this study was to explore how nursing staff talk about patient care in Swedish forensic psychiatric care and the implications for the care given to patients. The theoretical framework is based on social constructionism and sheds light on how language use can be understood as a social action. Twelve interviews were conducted with nursing staff working in forensic psychiatric settings. The questions focused on patient care in relation to activities, security, relationships with patients, and rules and routines. The results show that nursing staff assignments are encouraging them to use various interpretative repertoires to make meaning about their practice. The three interpretative repertoires were "taking responsibility for correcting patients' behavior," "justifying patient care as contradictory practice," and "patients as unpredictable." However, although forensic psychiatric care emphasizes both security and care, nursing staff's use of these interpretative repertoires provided multiple interpretations that lead to contradictory ways of understanding patient care. These findings show that talk itself can be understood as problematic in various situations. A possible implication for clinical forensic nursing practice might be that the nurse-patient relationship does not support patients' best interests. For example, when language endows the patient with certain characteristics, this talk is justified and given meaning by its context and thus has an influence on a patient's individual need for care.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2019
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-2739 (URN)10.1097/JFN.0000000000000227 (DOI)30640200 (PubMedID)
Available from: 2019-01-18 Created: 2019-01-18 Last updated: 2021-09-09Bibliographically approved
Pollak, C., Palmstierna, T., Kald, M. & Ekstrand, P. (2018). It Had Only Been a Matter of Time Before I Had Relapsed Into Crime: Aspects of Care and Personal Recovery in Forensic Mental Health. Journal of Forensic Nursing, 14(4), 230-237
Open this publication in new window or tab >>It Had Only Been a Matter of Time Before I Had Relapsed Into Crime: Aspects of Care and Personal Recovery in Forensic Mental Health
2018 (English)In: Journal of Forensic Nursing, ISSN 1939-3938, E-ISSN 1556-3693, Vol. 14, no 4, p. 230-237Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Forensic psychiatry has the dual task of focusing on the prevention of reoffending as well as maintaining psychiatric rehabilitation. No previous studies addressing the patients' own views on reducing their risk of serious reoffending were found.

AIM: This study describes forensic psychiatric inpatients' own views on what aspects of care and personal recovery are important in reducing their risk of serious reoffending.

METHODS: A structured qualitative approach was used. Data were collected from semistructured interviews and analyzed with a systematic qualitative content analysis.

RESULTS: The results highlight aspects of care and personal recovery. Four themes emerged: "time: opportunity for change," "trust: creating a context with meaningful relations," "hope: to reach a future goal," and "toolbox: tools needed for recovery."

DISCUSSION: The themes present with a continuum. At one end, there are patients who appreciated possibilities to participate actively in care and treatment. At the other end, patients felt they had no use for their care. Interestingly, although patients in our study were asked for their opinion on how they could reduce their dangerousness, all themes fit into established personal recovery processes found in general psychiatric populations. The theme "time: opportunity for change" seems to have an overarching importance.

IMPLICATIONS FOR PRACTICE: By understanding the specific content along these themes, relevant to the individual patient, carers may be able to better support their personal recovery journey. Because time spent as inpatients in forensic psychiatry is an overarching issue, carers need to be persistent over time.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2018
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-2612 (URN)10.1097/JFN.0000000000000210 (DOI)30080709 (PubMedID)
Available from: 2018-08-30 Created: 2018-08-30 Last updated: 2021-09-09Bibliographically approved
Ekstrand, P. (2017). Att  vara  eller  arbeta som  sjuksköterska: ett gränsöverskridande yrke (3ed.). In: Helén Strömberg och Henrik Eriksson (Ed.), Genusperspektiv på vård och omvårdnad: (pp. 87-105). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Att  vara  eller  arbeta som  sjuksköterska: ett gränsöverskridande yrke
2017 (Swedish)In: Genusperspektiv på vård och omvårdnad / [ed] Helén Strömberg och Henrik Eriksson, Lund: Studentlitteratur AB, 2017, 3, p. 87-105Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2017 Edition: 3
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-3088 (URN)9789144115788 (ISBN)
Available from: 2019-11-22 Created: 2019-11-22 Last updated: 2019-11-22Bibliographically approved
Ekstrand, P. & Saarnio, L. (2017). Makt och vanmakt hos patienter med svår sjukdom (3ed.). In: Helén Strömberg och Henrik Eriksson (Ed.), Genusperspektiv på vård och omvårdnad: (pp. 169-184). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Makt och vanmakt hos patienter med svår sjukdom
2017 (Swedish)In: Genusperspektiv på vård och omvårdnad / [ed] Helén Strömberg och Henrik Eriksson, Lund: Studentlitteratur AB, 2017, 3, p. 169-184Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2017 Edition: 3
National Category
Nursing
Identifiers
urn:nbn:se:rkh:diva-3089 (URN)9789144115788 (ISBN)
Available from: 2019-11-22 Created: 2019-11-22 Last updated: 2019-11-22Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7807-0584

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