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  • 1.
    Larsen, Joacim
    et al.
    Röda Korsets Högskola, Hälsovetenskapliga institutionen.
    Sigvardsdotter, Erika
    Röda Korsets Högskola, Hälsovetenskapliga institutionen.
    Silow Kallenberg, Kim
    Röda Korsets Högskola, Hälsovetenskapliga institutionen.
    Eriksson, Henrik
    Röda Korsets Högskola, Hälsovetenskapliga institutionen.
    The Delphi method as a way to explore underresearched areas in nursing: - refugee's health and social participation2018Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background: The Delphi method developed in the 1950s in the US-Army as a way to forecast the probability of nuclear weapons usage in war by consulting "experts". From this origin the Delphi method successfully spread in dierent academic disciplines during the late 1900 to become one important method for access "expert consensus" in situations where no other evidence exist and furthermore to provide a valuable tool in the investigation of "expert opinion" and may thereby help to guide future policy directives in an era such as nursing. Objective: The aim of this presentation is to describe the possibilities of using this approach to explore under-researched areas in nursing using conclusion drawn from a scoping review of Delphi studies on refugee's health and social participation. Method: Scoping review Results: The ndings show that health workers; nurse’s, physicians, civil servants have a tremendous impact on health outcomes that occur for refugees during their adjustment to a new life and that their interpretation and implementing policies is important to consider when elaborating on health and resources of health. Conclusion and implication for practice: To conclude, emphasizing the tacit knowledge of experts the ndings show that this type of approaches can serve as a method to both investigate and establish a consensus among nurses or in areas of nursing research where evidence is lacking. Delphi method is a tool that can provide valuable insight regarding nursing knowledge that is not possible to monitor in any other way and can become more important in nursing research in the future.

  • 2.
    Meier, Lars
    et al.
    Technische Universität Berlin, Germany.
    Frers, Lars
    Telemark University College, Norway.
    Sigvardsdotter, Erika
    Uppsala universitet, Kulturgeografiska institutionen.
    The importance of absence in the present: practices of remembrance and the contestation of absences2013Inngår i: Cultural Geographies, ISSN 1474-4740, E-ISSN 1477-0881, Vol. 20, nr 4 SI, s. 423-430Artikkel i tidsskrift (Annet vitenskapelig)
  • 3.
    Sigvardsdotter, Erika
    Uppsala universitet, Kulturgeografiska institutionen.
    Book review of Beside one’s self: Homelessness felt and lived by Catherine Robinson2013Inngår i: Emotion, Space and Society, ISSN 1755-4586, E-ISSN 1878-0040, Vol. 7, s. 74-75Artikkel, omtale (Annet vitenskapelig)
  • 4. Sigvardsdotter, Erika
    Book review of Seeking Asylum: Human smuggling and Bureaucracy at the border by Alison Mountz2011Inngår i: Environment & Planning. D, Society and Space, ISSN 0263-7758, E-ISSN 1472-3433, Vol. 29, nr 3, s. 568-570Artikkel, omtale (Annet vitenskapelig)
  • 5.
    Sigvardsdotter, Erika
    Röda Korsets Högskola, Avdelningen Medicin och Folkhälsa.
    En papperslös livsvärld: Utanförskapets fenomenologi2016Inngår i: Irreguljär migration i Sverige: Rättigheter, vardagserfarenheter, motstånd och statliga kategoriseringar / [ed] Maja Sager, Helena Holgersson, Klara Öberg, Göteborg: Daidalos, 2016, 1, s. 141-161Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 6.
    Sigvardsdotter, Erika
    Röda Korsets Högskola, Avdelningen Medicin och Folkhälsa.
    Krigs- och tortyrskadades vårdbehov: behovet av forskning och kopplingen till Röda Korsets Högskola2014Inngår i: Att bryta tystnaden: Årsrapport 2014 / [ed] Ansvarig utgivare: Eva Hall, Vårdenheten, Svenska Röda Korset, Svenska Röda Korset , 2014, s. 31-37Kapittel i bok, del av antologi (Annet (populærvitenskap, debatt, mm))
  • 7.
    Sigvardsdotter, Erika
    Uppsala universitet, Kulturgeografiska institutionen.
    Papperslösas rätt till vård: Bristen på lagstiftning lägger stort ansvar på vårdpersonalen2010Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, nr 23Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    Undocumented migrants in Sweden have no regulated access to health care, but as legislation forbids anyone to be denied “immediate” care at their own expense when in need, this applies also to them. In lack of specific national regulations, local policies on the issue have been formed. This study, based on interviews with civil servants on the local levels and representatives of NGO clinics as well as the study of relevant national legislation and local policies, concludes that the local policies formed may be categorized into three groups: regulations that merely clarify the implications of current national legislation, regulations that incorporates the group “undocumented migrants” in “asylum seekers” and equates their entitlements, and finally, regulations that widen undocumented migrants’ access to health care from ”immediate” care to also include ”immediately necessary” care. These ambiguities put a heavy responsibility on the individual practitioner, and clearer, well-communicated regulations would help solve this situation.

  • 8.
    Sigvardsdotter, Erika
    Uppsala universitet, Kulturgeografiska institutionen.
    Presenting Absent Bodies: Undocumented Persons Coping and Resisting in Sweden2013Inngår i: Cultural Geographies, ISSN 1474-4740, E-ISSN 1477-0881, Vol. 20, nr 4 SI, s. 523-539Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Absence and presence have generally been discussed as two aspects of either a temporal or a spatial relationship. With an Arendtian notion of presence as the capacity to define space and to appear in front of others, this article explores undocumentedness as a condition of simultaneous presence and absence. Drawing on ethnographic fieldwork and interviews with undocumented persons in Sweden, it is argued that the undocumented spatiality is paradoxical and Möbius. This article shows how concealment, disguise, diffusion and appearance are key to the different manifestations of presence and absence in undocumented people’s lives. It also shows how undocumented persons, by using their politically absent yet physically present bodies as vehicles for practicing dissensus, can find possibilities for recognition and action in public space.

  • 9.
    Sigvardsdotter, Erika
    Uppsala universitet, Kulturgeografiska institutionen.
    Presenting the Absent: An Account of Undocumentedness in Sweden2012Doktoravhandling, monografi (Annet vitenskapelig)
    Abstract [en]

    This thesis provides an ethnography and critical phenomenology of undocumentedness in the Swedish context. By attending to the forces and processes that circumscribe the life-worlds of undocumented persons, as well as the phenomenology and essential experiences of their condition, a complex and multi-layered illustration of what undocumentedness is and means is successively presented. Employing a dual conceptualization of the state, as a juridico-political construct as well as a practiced and embodied set of institutions, the undocumented position emerges as a legal category defined only through omission, produced and reproduced through administrative routine and practice. The health care sector provides empirical examples of state-undocumented interaction where the physical and corporeal presence of the officially absent becomes irrefutable. This research suggests that the Swedish welfare state – universalistic, comprehensive and with digitized administrative routines – becomes a particularly austere environment in which to be undocumented.

    Drawing on interviews with regional and local health care administrators, NGO-clinics’ representatives and health professionals, as well as extensive participatory observation and interviews with undocumented persons, I argue that the undocumented condition is characterized by simultaneous absence and presence, and a correspondingly paradoxical spatiality. I suggest that the official absence and deportability of undocumented persons deprives them of the capacity to define space and, in an Arendtian sense, appear as themselves to others. There are, however, some opportunities for embodied political protest and dissensus. The paradoxical qualities of the absent-present condition manipulate the undocumented mode of being-in-the-world and I argue that alienation and disorientation are essential experiences of the undocumented situation.  

  • 10.
    Sigvardsdotter, Erika
    et al.
    Röda Korsets Högskola, Avdelningen Medicin och Folkhälsa.
    Malm, Andreas
    Röda Korsets Högskola, Avdelningen Medicin och Folkhälsa. Karolinska Institutet / Swedish Red Cross Treatment Center for Persons Affected by War and Torture.
    Tinghög, Petter
    Röda Korsets Högskola, Avdelningen Medicin och Folkhälsa. Karolinska Institutet.
    Vaez, Marjan
    Karolinska Institutet.
    Saboonchi, Fredrik
    Röda Korsets Högskola, Avdelningen Medicin och Folkhälsa. Karolinska Institutet.
    Refugee trauma measurement: a review of existing checklists2016Inngår i: Public Health Reviews, ISSN 0301-0422, E-ISSN 2107-6952, Vol. 37, artikkel-id 10Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Studies have shown that a high proportion of refugees have been subjected to potentially traumatic experiences (PTEs). PTEs, including torture, are powerful predictors of mental ill health. This paper reports a review of refugee trauma history self-report measures used in population studies.

    Methods

    A review of existing instruments and checklists, up to September 2015, was performed.

    Results

    The types of measures for refugee trauma history vary from semi-structured interviews and medical records to extensive multi-item trauma-checklists. The Harvard Trauma Questionnaire (HTQ) was the most commonly used instrument for measuring trauma history among refugee populations. Few checklists included PTEs during the flight.

    Conclusion

    Trauma history checklists are often used as a tool to control for background variables when studying refugees’ mental health and have mostly been developed in clinical or semi-clinical settings. There is a need for acceptable, reliable and valid brief checklists for measuring trauma in refugees, for the purpose of performing larger scale population studies.

  • 11.
    Sigvardsdotter, Erika
    et al.
    Röda Korsets Högskola, Hälsovetenskapliga institutionen.
    Nilsson, Henrik
    Röda Korsets Högskola, Hälsovetenskapliga institutionen. Karolinska Institutet / Swedish Red Cross Center for Persons Affected by War and Torture.
    Malm, Andreas
    Röda Korsets Högskola, Hälsovetenskapliga institutionen. Swedish Red Cross Center for Persons Affected by War and Torture.
    Tinghög, Petter
    Röda Korsets Högskola, Hälsovetenskapliga institutionen. Karolinska Institutet.
    Gottvall, Maria
    Röda Korsets Högskola, Hälsovetenskapliga institutionen. Uppsala University.
    Vaez, Marjan
    Karolinska Institutet.
    Saboonchi, Fredrik
    Röda Korsets Högskola, Hälsovetenskapliga institutionen. Karolinska Institutet.
    Development and Preliminary Validation of Refugee Trauma History Checklist (RTHC)-A Brief Checklist for Survey Studies2017Inngår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 14, nr 10, artikkel-id 1175Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A high proportion of refugees have been subjected to potentially traumatic experiences (PTEs), including torture. PTEs, and torture in particular, are powerful predictors of mental ill health. This paper reports the development and preliminary validation of a brief refugee trauma checklist applicable for survey studies.

    METHODS: A pool of 232 items was generated based on pre-existing instruments. Conceptualization, item selection and item refinement was conducted based on existing literature and in collaboration with experts. Ten cognitive interviews using a Think Aloud Protocol (TAP) were performed in a clinical setting, and field testing of the proposed checklist was performed in a total sample of n = 137 asylum seekers from Syria.

    RESULTS: The proposed refugee trauma history checklist (RTHC) consists of 2 × 8 items, concerning PTEs that occurred before and during the respondents' flight, respectively. Results show low item non-response and adequate psychometric properties Conclusion: RTHC is a usable tool for providing self-report data on refugee trauma history surveys of community samples. The core set of included events can be augmented and slight modifications can be applied to RTHC for use also in other refugee populations and settings.

  • 12.
    Sigvardsdotter, Erika
    et al.
    Röda Korsets Högskola, Avdelningen Medicin och Folkhälsa.
    Vaez, Marjan
    Karolinska Institutet.
    Hedman, Ann-Marie
    Röda Korsets Högskola, Avdelningen Vård och Omvårdnad.
    Saboonchi, Fredrik
    Röda Korsets Högskola, Avdelningen Medicin och Folkhälsa. Karolinska Institutet.
    Prevalence of torture and other war-related traumatic events in forced migrants: A systematic review2016Inngår i: Journal on Rehabilitation of Torture Victims and Prevention of Torture, ISSN 1018-8185, E-ISSN 1997-3322, Vol. 26, nr 2, s. 41-73Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To describe and appraise the research literature reporting prevalence of torture and/or war-related potentially traumatic experiences (PTEs) in adult forced migrants living in high-income countries.

    Methods: A search for peer-reviewed articles in English was conducted in PubMed, Web of Science, PILOTS, key journals, and reference lists. Studies based on clinical samples and samples where less than half of participants were forced migrants were excluded. Data was extracted and a methodological quality appraisal was performed.

    Results: A total of 3,470 titles and abstracts were retrieved and screened. Of these, 198 were retrieved in full-text. Forty-one articles fulfilled inclusion criteria and the total number of study participants was 12,020 (median 170). A majority focused on specific ethnic groups or nationalities, Southeast Asian, Middle Eastern and Balkan being the most frequent. Reported prevalence rates of torture ranged between one and 76 % (median 27 %). Almost all participants across all studies had experienced some kind of war-related PTE.

    Conclusions: Reported prevalence rates of torture and war-related PTEs vary between groups of forced migrants. Trauma history was often studied as a background variable in relation to mental health. The heterogeneity of data, as well as the methodological challenges in reaching forced migrants and defining and measuring traumatic experiences, prevent generalisation concerning trauma history across groups.

  • 13.
    Tinghög, Petter
    et al.
    Röda Korsets Högskola, Avdelningen Medicin och Folkhälsa.
    Arwidson, Charlotta
    Röda Korsets Högskola, Avdelningen Medicin och Folkhälsa.
    Sigvardsdotter, Erika
    Röda Korsets Högskola, Avdelningen Medicin och Folkhälsa.
    Malm, Andreas
    Röda Korsets Högskola, Avdelningen Medicin och Folkhälsa. Svenska Röda Korset.
    Saboonchi, Fredrik
    Röda Korsets Högskola, Avdelningen Medicin och Folkhälsa.
    Nyanlända och asylsökande i Sverige: En studie av psykisk ohälsa, trauma och levnadsvillkor2016Rapport (Annet vitenskapelig)
    Abstract [sv]

    Människor som flyr från krig och konflikt har ofta varit med om omskakande händelser som kan leda till långvariga problem och ohälsa. Det finns lite kunskap om hur sådana erfarenheter påverkar en människa. För att öka kunskapen genomfördes under perioden maj 2015 till oktober 2016, en forskningsstudie vid Röda Korsets Högskola. Studien hade som syfte att uppskatta förekomsten av psykisk ohälsa bland nyanlända från Syrien och asylsökande från Eritrea, Syrien och Somalia samt att kartlägga förekomsten av erfarenheter av traumatiska händelser, post-migratorisk stress och svagt socialt stöd.

    Data har samlats in via två enkäter samt register i två kompletterande studiepopulationer. Den första studiepopulationen bestod av 1215 nyanlända från Syrien med permanent uppehållstillstånd som blivit kommunmottagna mellan åren 2011 och 2013. Den andra studiepopulationen bestod av 173 asylsökande från Syrien, Eritrea och Somalia som bodde på ett asylboende i västra Sverige.

    Resultaten från studien visar bland annat att den psykiska ohälsan i Sverige 2016 är mycket utbredd bland nyanlända från Syrien och bland asylsökande från Eritrea, Somalia och Syrien. Bland nyanlända från Syrien har var tredje en högst påtaglig depressions- eller ångestproblematik, detta samtidigt som 30 % uppger symtom som stämmer överens med posttraumatiskt stressyndrom (PTSD). Studien indikerar dessutom att psykisk ohälsa i form av depression, ångest, PTSD och lågt välbefinnande är betydligt vanligare bland asylsökande än bland nyanlända, särskilt bland asylsökande från Eritrea och Somalia.

  • 14.
    Tinghög, Petter
    et al.
    Röda Korsets Högskola, Hälsovetenskapliga institutionen. Karolinska Institutet.
    Malm, Andreas
    Röda Korsets Högskola, Hälsovetenskapliga institutionen. Karolinska Institutet / The Swedish Red Cross Treatment Center for Persons Affected by War and Torture.
    Arwidson, Charlotta
    Röda Korsets Högskola, Hälsovetenskapliga institutionen.
    Sigvardsdotter, Erika
    Röda Korsets Högskola, Hälsovetenskapliga institutionen.
    Lundin, Andreas
    Karolinska Institutet.
    Saboonchi, Fredrik
    Röda Korsets Högskola, Hälsovetenskapliga institutionen. Karolinska Institutet.
    Prevalence of mental ill health, traumas and postmigration stress among refugees from Syria resettled in Sweden after 2011: a population-based survey2017Inngår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, nr 12, artikkel-id e018899Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: To estimate the prevalence of and associations between anxiety, depression, post-traumatic stress disorder (PTSD), low subjective well-being (SWB), potential traumas and postmigration stress among refugees from Syria resettled in Sweden.

    DESIGN: A cross-sectional and population-based questionnaire study based on a known and complete sample frame. The survey included multiple measures of mental ill health and factors of particular relevance for refugees. Weighted analyses were conducted to calculate representative prevalence rates and associations. Associations were investigated through a series of logistic regression analyses. All analyses were supplemented with robust 95% CIs.

    SETTING: Sweden.

    PARTICIPANTS: A random sample of 1215 individuals (response rate 30.4%) from Syria aged 18-64 years that were granted residency in Sweden on grounds of asylum between 2011 and 2013.

    MAIN OUTCOME MEASURES: Anxiety, depression, PTSD and low SWB were assessed through Hopkins Symptom Checklist, Harvard Trauma Questionnaire and WHO-5 Well-being Index, using established cut-offs.

    RESULTS: A majority of the participants met the criteria for at least one of the studied types of mental ill health, and the comorbidity was high. Depression was the most the common type with 40.2% (95% CI 36.9% to 43.3%), followed by low SWB with 37.7% (95% CI 34.8% to 40.1%), anxiety with 31.8% (95% CI 29.2% to 34.7%) and PTSD with 29.9% (95% CI 27.2% to 32.6%). Refugee-related potentially traumatic events (PTEs) experienced before or during migration was common as was substantial levels of postmigration stress. Most types of refugee-related PTEs, especially being exposed to interpersonal violence, and postmigration stress were associated with increased risks for anxiety, depression, low SWB and PTSD.

    CONCLUSIONS: Mental ill health, in terms of anxiety, depression, low SWB and PTSD, are highly elevated and comorbid among refugees from Syria. Increased attention from multiple societal sectors to adequately support Syrian refugees' mental health needs, promoting recovery and reducing postmigration stress are needed.

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