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  • 1.
    Gottvall, Maria
    Uppsala universitet, Vårdvetenskap.
    Introduction of School-Based HPV Vaccination in Sweden: Knowledge and Attitudes among Youth, Parents, and Staff2014Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    The overall aim of this thesis is to provide a better understanding of knowledge, attitudes, consent, and decision-making regarding Human papillomavirus (HPV) vaccination, seen from the perspectives of concerned parties – high school students, school nurses, and parents.

    Two quantitative studies were performed: one descriptive cross-sectional study and one quasi-experimental intervention study. Qualitative studies using focus group interviews and individual interviews were also performed.

    High school students’ knowledge about HPV and HPV prevention was low but their attitudes toward HPV vaccination were positive. An educational intervention significantly increased the students’ knowledge regarding HPV and HPV prevention. Their already positive attitudes toward condom use and HPV vaccination remained unchanged. The students wanted to receive more information about HPV from school nurses. The school nurses were also positive to HPV vaccination but identified many challenges concerning e.g. priorities, obtaining informed consent, culture, and gender. They saw an ethical dilemma in conflicting values such as the child’s right to self-determination, the parents’ right to make autonomous choices on behalf of their children, and the nurse’s obligation to promote health. They were also unsure of how, what, and to whom information about HPV should be given. Parents, who had consented to vaccination of their young daughters, reasoned as follows: A vaccine recommended by the authorities is likely to be safe and effective, and the parents were willing to do what they could to decrease the risk of a serious disease for their daughter. Fear of unknown adverse events was overweighed by the benefits of vaccination. Parents also saw the school nurse as an important source of HPV information.

    Conclusions: Positive attitudes toward HPV vaccination despite limited knowledge about HPV, are overarching themes in this thesis. School nurses have a crucial role to inform about HPV prevention. It is important that the concerned parties are adequately informed about HPV and its preventive methods, so that they can make an informed decision about vaccination. A short school-based intervention can increase knowledge about HPV among students. From a public health perspective, high vaccination coverage is important as it can lead to a reduced number of HPV-related disease cases. 

  • 2.
    Gottvall, Maria
    et al.
    Uppsala universitet, Vårdvetenskap.
    Grandahl, Maria
    Uppsala universitet, Vårdvetenskap.
    Höglund, Anna T.
    Uppsala universitet, Centrum för forsknings- och bioetik.
    Larsson, Margareta
    Uppsala universitet, Obstetrik & gynekologi.
    Stenhammar, Christina
    Uppsala universitet, Vårdvetenskap.
    Andrae, Bengt
    Uppsala universitet, Centrum för klinisk forskning, Gävleborg.
    Tydén, Tanja
    Uppsala universitet, Vårdvetenskap.
    Trust versus concerns: how parents reason when they accept HPV vaccination for their young daughter2013Inngår i: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 118, nr 4, s. 263-270Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background. From spring of 2012, human papillomavirus (HPV) vaccine against cervical cancer is offered free of charge to all girls aged 10-12 years through a school-based vaccination programme in Sweden. The aim of this study was to explore how parents reason when they accept HPV vaccination for their young daughter and also their views on HPV-related information. Methods. Individual interviews with parents (n = 27) of 11-12-year-old girls. The interviews were recorded, transcribed verbatim, and analysed using thematic content analysis. Results. Three themes emerged through the analysis: Trust versus concern, Responsibility to protect against severe disease, and Information about HPV and HPV vaccination is important. The parents expressed trust in recommendations from authorities and thought it was convenient with school-based vaccination. They believed that cervical cancer was a severe disease and felt a responsibility to protect their daughter from it. Some had certain concerns regarding side effects and vaccine safety, and wished for a dialogue with the school nurse to bridge the information gaps. Conclusions. Trust in the recommendations from authorities and a wish to protect their daughter from a severe disease outweighed concerns about side effects. A school-based vaccination programme is convenient for parents, and the school nurse has an important role in bridging information gaps. The findings from this qualitative study cannot be generalized; however, it can provide a better understanding of how parents might reason when they accept the HPV vaccination for their daughter.

  • 3.
    Gottvall, Maria
    et al.
    Uppsala universitet, Vårdvetenskap.
    Larsson, Margareta
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Höglund, Anna T
    Uppsala universitet, Centrum för forsknings- och bioetik.
    Tydén, Tanja
    Uppsala universitet, Vårdvetenskap.
    High HPV vaccine acceptance despite low awareness among Swedish upper secondary school students2009Inngår i: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 14, nr 6, s. 399-405Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To investigate knowledge of human papillomavirus (HPV) and attitudes to HPV vaccination and condom use among Swedish first year upper secondary school students. METHODS: Classroom questionnaire filled in by 608 students from a strategic sample of seven upper secondary schools in Sweden. RESULTS: Only 13.5% (n = 82) of the students had heard about HPV and 6% (n = 35) were aware of HPV vaccination. As many as 84% (n = 508) would like to be vaccinated against HPV. The high cost of vaccination was the greatest obstacle (total group 37%, n = 227); among girls the second major hindrance was the fear of needles (19%, n = 65). Before considering an HPV vaccination 73% (n = 443) wanted more information and 36% (n = 220) would like to receive such information from the school nurse. The students considered it less likely that they would use a condom when having intercourse with a new partner if they were vaccinated than if they were not (p < 0.001). CONCLUSION: Despite intensive marketing directed at potential vaccine consumers, knowledge of HPV and of HPV vaccines was very low among first year upper secondary school students. Their attitude towards vaccination was positive but most of them wanted more information before considering vaccination.

  • 4.
    Gottvall, Maria
    et al.
    Röda Korsets Högskola, Hälsovetenskapliga institutionen. Uppsala University.
    Sjölund, Sara
    Röda Korsets Högskola, Hälsovetenskapliga institutionen.
    Arwidson, Charlotta
    Röda Korsets Högskola, Hälsovetenskapliga institutionen.
    Saboonchi, Fredrik
    Röda Korsets Högskola, Hälsovetenskapliga institutionen. Karolinska Instiutet.
    Health-related quality of life among Syrian refugees resettled in Sweden2019Inngår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose The main purpose of this study was to assess health-related quality of life (HRQoL) among Syrian refugees resettled in Sweden. Further, we wanted to investigate whether sex, age, education, area of residence, cohabitation and social support were associated with HRQoL in this population. Methods This is a cross-sectional study including 1215 Syrian refugees from a randomly selected sample frame resettled in Sweden between the years 2011 and 2013. HRQoL was measured by the EQ-5D-5L descriptive system, and EQ-5D-5L index values were calculated. Associations between sex, age, education, area of residence, cohabitation, social support and EQ-5D-5L were investigated using multiple linear regression analysis. Results Depression/anxiety was the most commonly (61.9%) reported EQ-5D-5L problem among the group of Syrian refugees. The mean EQ-5D-5L index value was found to be 0.754. Male sex, younger age, cohabitation and social support were found associated with a higher EQ-5D-5L index score. Conclusions Our results concerning long-lasting health problems among the study population indicate that there is a profound need for policies and interventions promoting refugees' health. Our results also show that social support, a modifiable factor, is relevant to refugees' overall health, pointing to the importance of public health interventions and policies targeting the facilitation, mobilization and enhancing of refugees' social support.

  • 5.
    Gottvall, Maria
    et al.
    Röda Korsets Högskola, Avdelningen Medicin och Folkhälsa. Uppsala University.
    Stenhammar, Christina
    Uppsala University.
    Grandahl, Maria
    Uppsala University.
    Parents' views of including young boys in the Swedish national school-based HPV vaccination programme: a qualitative study2017Inngår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 7, nr 2, artikkel-id e014255Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To explore parents' views of extending the human papillomavirus (HPV) vaccination programme to also include boys.

    DESIGN: Explorative qualitative design using individual, face-to-face, interviews and inductive thematic analysis.

    SETTING: 11 strategically chosen municipalities in central Sweden.

    PARTICIPANTS: Parents (n=42) who were offered HPV vaccination for their 11-12 years old daughter in the national school-based vaccination programme.

    RESULTS: The key themes were: equality from a public health perspective and perception of risk for disease. Parents expressed low knowledge and awareness about the health benefits of male HPV vaccination, and they perceived low risk for boys to get HPV. Some parents could not see any reason for vaccinating boys. However, many parents preferred gender-neutral vaccination, and some of the parents who had not accepted HPV vaccination for their daughter expressed that they would be willing to accept vaccination for their son, if it was offered. It was evident that there was both trust and distrust in authorities' decision to only vaccinate girls. Parents expressed a preference for increased sexual and reproductive health promotion such as more information about condom use. Some parents shared that it was more important to vaccinate girls than boys since they believed girls face a higher risk of deadly diseases associated with HPV, but some also believed girls might be more vulnerable to side effects of the vaccine.

    CONCLUSIONS: A vaccine offered only to girls may cause parents to be hesitant to vaccinate, while also including boys in the national vaccination programme might improve parents' trust in the vaccine. More information about the health benefits of HPV vaccination for males is necessary to increase HPV vaccination among boys. This may eventually lead to increased HPV vaccine coverage among both girls and boys.

  • 6.
    Gottvall, Maria
    et al.
    Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap.
    Tydén, Tanja
    Uppsala universitet, Vårdvetenskap.
    Höglund, Anna T
    Uppsala universitet, Centrum för forsknings- och bioetik.
    Larsson, Margareta
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Knowledge of human papillomavirus among high school students can be increased by an educational intervention2010Inngår i: International Journal of STD and AIDS (London), ISSN 0956-4624, E-ISSN 1758-1052, Vol. 21, nr 8, s. 558-562Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to evaluate the effect of an educational intervention concerning human papillomavirus (HPV) directed at Swedish first year high school students. The intervention consisted of a class room lesson, a website and a folder. Outcome variables were knowledge of HPV and attitudes to preventive methods such as HPV vaccination, condom use and Pap smear testing. An intervention group (n = 92) was matched with two comparison groups (n = 184). At baseline, the median score for HPV knowledge was one out of 10 in both groups. At follow-up, the median knowledge score had increased to six in the intervention group, but was still one in the comparison group (P < 0.001). Attitudes to HPV vaccination, condom use and Pap smear testing remained the same (P > 0.05). In conclusion, a short school-based intervention can greatly increase the students' knowledge about HPV, but attitudes and behaviours are less easy to influence.

  • 7.
    Gottvall, Maria
    et al.
    Uppsala universitet, Vårdvetenskap.
    Tydén, Tanja
    Uppsala universitet, Vårdvetenskap.
    Larsson, Margareta
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Stenhammar, Christina
    Uppsala universitet, Institutionen för kvinnors och barns hälsa.
    Höglund, Anna T
    Uppsala universitet, Centrum för forsknings- och bioetik.
    Challenges and opportunities of a new HPV immunization program: Perceptions among swedish school nurses2011Inngår i: Vaccine, ISSN 0264-410X, E-ISSN 1873-2518, Vol. 29, s. 4576-4583Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim To investigate school nurses’ perceptions of HPV immunization, and their task of administering the vaccine in a planned school-based program in Sweden. Method: Data were collected through five focus group interviews with school nurses (n = 30). The interviews were recorded, transcribed verbatim and analyzed using content analysis.

    Findings The theme Positive attitude to HPV immunization despite many identified problems and challenges summarizes the results. The school nurses saw the program as a benefit in that the free school-based HPV immunization program could balance out social inequalities. However, they questioned whether this new immunization program should be given priority given their already tight schedule. Some also expressed doubts regarding the effect of the vaccine. It was seen as challenging to obtain informed consent as well as to provide information regarding the vaccine. The nurses were unsure of whether boys and their parents should also be informed about the immunization.

    Conclusion Although some positive aspects of the new HPV immunization program were mentioned, the school nurses primarily identified problems and challenges; e.g. regarding priority setting, informed consent, culture and gender. In order to achieve a good work environment for the school nurses, and obtain a high coverage rate for the HPV immunization, these issues need to be taken seriously, be discussed and acted upon.

  • 8.
    Gottvall, Maria
    et al.
    Uppsala universitet, Vårdvetenskap.
    Tydén, Tanja
    Uppsala universitet, Vårdvetenskap.
    Larsson, Margareta
    Uppsala universitet, Obstetrik & gynekologi.
    Stenhammar, Christina
    Uppsala universitet, Vårdvetenskap.
    Höglund, Anna T
    Uppsala universitet, Centrum för forsknings- och bioetik.
    Informed Consent for HPV Vaccination: A Relational Approach2015Inngår i: Health Care Analysis, ISSN 1065-3058, E-ISSN 1573-3394, Vol. 23, nr 1, s. 50-62Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to explore the relational aspects of the consent process for HPV vaccination as experienced by school nurses, based on the assumption that individuals have interests related to persons close to them, which is not necessarily to be apprehended as a restriction of autonomy; rather as a voluntary and emotionally preferred involvement of their close ones. Thirty Swedish school nurses were interviewed in five focus groups, before the school based vaccination program had started in Sweden. The empirical results were discussed in light of theories on relational autonomy. The school nurses were convinced that parental consent was needed for HPV vaccination of 11-year-old girls, but problems identified were the difficulty to judge when a young person is to be regarded as autonomous and what to do when children and parents do not agree on the decision. A solution suggested was that obtaining informed consent in school nursing is to be seen as a deliberative process, including the child, the parents and the nurse. The nurses described how they were willing strive for a dialogue with the parents and negotiate with them in the consent process. Seeing autonomy as relational might allow for a more dialogical approach towards how consent is obtained in school based vaccination programs. Through such an approach, conflicts of interests can be made visible and become possible to deal with in a negotiating dialogue. If the school nurses do not focus exclusively on accepting the individual parent's choice, but strive to engage in a process of communication and deliberation, the autonomy of the child might increase and power inequalities might be reduced.

  • 9.
    Gottvall, Maria
    et al.
    Röda Korsets Högskola, Hälsovetenskapliga institutionen. Uppsala University.
    Vaez, Marjan
    Röda Korsets Högskola, Hälsovetenskapliga institutionen. Karolinska Institutet.
    Saboonchi, Fredrik
    Röda Korsets Högskola, Hälsovetenskapliga institutionen. Karolinska Institutet.
    Social support attenuates the link between torture exposure and post-traumatic stress disorder among male and female Syrian refugees in Sweden2019Inngår i: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 19, nr 1, artikkel-id 28Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: The aim of this study is threefold: (i) to establish the psychometric properties and gender invariance of ENRICHD Social Support Inventory (ESSI), which was used for the first time in the present study in the population of Syrian refugees resettled in Sweden; (ii) to assess whether gender moderates the associations between social support, exposure to torture and PTSD; (iii) to assess whether social support mediates the association between exposure to torture and PTSD, and whether this mediation is in turn moderated by gender.

    METHODS: Data from a cross-sectional and population-based study of a random sample of Syrian refugees (n = 1215) resettled in Sweden 2011-2013 was analyzed within a Structural Equation Modeling (SEM) framework.

    RESULTS: Our results indicate adequate fit and gender invariance for a unidimensional model of ESSI. Exposure to torture was associated with lower social support (B = -0.22, p < 0.01) and with higher odds ratio (OR) for PTSD (OR 2.52, 95% Confidence interval (CI) 1.83-3.40). Furthermore, higher social support was associated with less likelihood for PTSD (B = -0.56, p < 0.001). Social support partially mediated the effect of torture exposure on PTSD (OR 1.13, 95% bias corrected bootstrap CI 1.06-1.26). Gender did not moderate this pattern.

    CONCLUSION: The results indicate that social support attenuates the link between torture exposure and PTSD, and may function as a protective factor for PTSD among both torture-exposed refugee men and women.

  • 10.
    Grandahl, Maria
    et al.
    Uppsala universitet, Vårdvetenskap.
    Tyden, Tanja
    Uppsala universitet, Vårdvetenskap.
    Gottvall, Maria
    Uppsala universitet, Vårdvetenskap.
    Westerling, Ragnar
    Uppsala universitet, Socialmedicin.
    Oscarsson, Marie
    Uppsala universitet, Vårdvetenskap / School of Health and Caring, Linnaeus University,.
    Immigrant women’s experiences and views on the prevention of cervical cancer: a qualitative study2015Inngår i: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 18, nr 3, s. 344-354Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background

    Many Western countries have cervical cancer screening programmes and have implemented nation-wide human papillomavirus (HPV) vaccination programmes for preventing cervical cancer.

    Objective

    To explore immigrant women's experiences and views on the prevention of cervical cancer, screening, HPV vaccination and condom use.

    Design

    An exploratory qualitative study. The Health Belief Model (HBM) was used as a theoretical framework.

    Setting and participants

    Eight focus group interviews, 5–8 women in each group (average number 6,5), were conducted with 50 women aged 18–54, who studied Swedish for immigrants. Data were analysed by latent content analysis.

    Results

    Four themes emerged: (i) deprioritization of women's health in home countries, (ii) positive attitude towards the availability of women's health care in Sweden, (iii) positive and negative attitudes towards HPV vaccination, and (iv) communication barriers limit health care access. Even though the women were positive to the prevention of cervical cancer, several barriers were identified: difficulties in contacting health care due to language problems, limited knowledge regarding the relation between sexual transmission of HPV and cervical cancer, culturally determined gender roles and the fact that many of the women were not used to regular health check-ups.

    Conclusion

    The women wanted to participate in cervical cancer prevention programmes and would accept HPV vaccination for their daughters, but expressed difficulties in understanding information from health-care providers. Therefore, information needs to be in different languages and provided through different sources. Health-care professionals should also consider immigrant women's difficulties concerning cultural norms and pay attention to their experiences.

  • 11.
    Kohi, Thecla W
    et al.
    Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
    von Essen, Louise
    Uppsala University.
    Masika, Golden M
    Chinese University of Hong Kong, Shatin, Hong Kong / University of Dodoma, Dodoma, Tanzania.
    Gottvall, Maria
    Röda Korsets Högskola, Hälsovetenskapliga institutionen. Uppsala University.
    Dol, Justine
    Dalhousie University, Halifax, Canada.
    Cancer-related concerns and needs among young adults and children on cancer treatment in Tanzania: a qualitative study2019Inngår i: BMC Cancer, ISSN 1471-2407, E-ISSN 1471-2407, Vol. 19, nr 1, artikkel-id 82Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Cancer is one of the leading causes of morbidity and mortality worldwide. Seventy percent of deaths of cancer occur in low or middle-income countries, where the resources to provide cancer treatment and care are minimal. Tanzania currently has very inadequate facilities for cancer treatment as there are only five sites, some with limited services; two are in Dar es Salaam and one each in Mwanza, Kilimanjaro and Mbeya that offer cancer treatment. Despite cancer being a prevalent problem in Tanzania, there is a significant shortage of information on the experiences of young people who receive cancer treatment and care. The aim of this study was to explore cancer-related concerns and needs of care and support among young adults and children who are receiving cancer treatment in Dar es Salaam, Tanzania.

    METHODS: Using an explorative, qualitative design, two focus group discussions (FGDs) with young adults (18 to 25 years) and four FGDs with children (9 to 17 years) were held. Data were transcribed into English and analyzed using content analysis.

    RESULTS: Identified concerns included physical effects, emotional effects, financial impacts, poor early care, and poor treatment. Identified needs included the need for improved care in hospital by the staff, need for community support, financial needs, needs for improved cancer care and treatment in the hospitals, and the need for increased education about cancer. Resilience was identified, particularly around hope or faith, having hope to be healed, and receiving good care from staff.

    CONCLUSION: Young adults and children receiving cancer treatment in Tanzania have many needs and concerns. Improvements with regard to the care provided in hospital by the staff, the cancer care and treatment in the hospital, and population-wide education about cancer are necessary to address the identified needs and concerns. Further studies on specific approaches to address the concerns and needs are also warranted.

  • 12.
    Masika, Golden M
    et al.
    University of Dodoma, Dodoma, Tanzania / Chinese University of Hong Kong, Hong Kong.
    Gottvall, Maria
    Röda Korsets Högskola, Hälsovetenskapliga institutionen. Uppsala University.
    Kohi, Thecla W
    Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
    von Essen, Louise
    Uppsala University.
    Dol, Justine S
    Dalhousie University, Halifax, Nova Scotia, Canada.
    Concerns and Needs of Support Among Guardians of Children on Cancer Treatment in Dar es Salaam: A Qualitative Study2019Inngår i: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Cancer in children in Tanzania is a concerning health issue, yet there is a shortage of information about the experiences of the guardians of children who receive cancer treatment.

    OBJECTIVE: To explore concerns and needs of support among guardians of children on cancer treatment in Dar es Salaam, Tanzania.

    METHOD: Using a qualitative design, 3 focus group discussions were held with 22 guardians of children aged 9 to 17 years. Guardians were recruited from Muhimbili National Hospital, Dar es Salaam, where their children were receiving cancer treatment. Data were analyzed using thematic content analysis.

    RESULTS: Guardians experienced several issues during the initial stages of their child's cancer treatment, including the process of seeking a diagnosis, and experiences with care at the peripheral (regional) hospitals and national hospital. They also shared what they felt would lessen their difficult experiences. Seven themes emerged in this study: financial concerns, emotional concerns, barriers to cancer care, need for improved cancer care, need for information, need for tangible support, and gratitude and hope.

    CONCLUSION: Guardians of children with cancer experience challenges during initial stages when seeking a diagnosis and have concerns and needs related to cancer care and treatment.

    IMPLICATIONS FOR PRACTICE: Improvements are needed regarding care at regional hospitals, the cancer diagnosis, and the recognition of early signs of cancer and quick referral to diagnostic centers, compassionate caring behaviors by healthcare workers, budgetary support from the government to meet the medication supply demands, and meeting stakeholders' support needs.

  • 13.
    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.

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