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Sandlund, Mikael
Publications (10 of 136) Show all publications
Sandlund, M., Grönlund, A.-S. & Blom-Nilsson, M. (2023). Att förbättra vården vid missbruk – hur gör man?. Socialmedicinsk Tidskrift, 1(5), 648-654
Open this publication in new window or tab >>Att förbättra vården vid missbruk – hur gör man?
2023 (Swedish)In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 1, no 5, p. 648-654Article in journal (Refereed) Published
Abstract [en]

Artikeln ger en kort bakgrund om svensk missbruksvård. De forskningsprojekt vars resultat detta temanummer bygger på har uppstått utifrån denna förståelse. Förkortningarna EPI och ESTR får också sina förklaringar och beskrivs. Det finns en rad svar på rubrikens fråga. Det vanligaste är att det skulle behövas en generell ambitionshöjning, något som anses kräva mer resurser, vilket inte är så enkelt att ordna. Ett annat svar är att huvudmännens ansvar borde förtydligas, vilket redan en nu 12 år gammal offentlig utredning föreslog via ett samlat huvudmannaskap hos sjukvårdshuvudmannen för behandling vid missbruk och beroende (SOU 2011:35). En aktuell utredning föreslår samma sak (SOU 2023:5). Hur det verkligen blir återstår att se. Alldeles oberoende av reformer så finns det möjligheter till kvalitetsförbättringar och effektiviseringar genom att planera och följa upp de insatser som erbjuds brukarna på ett systematiskt sätt.

Keywords
Missbruksvård, insatser, kvalitet, effektivisering, systematisk uppföljning, evidensbaserad praktik
National Category
Social Work
Research subject
Sociology
Identifiers
urn:nbn:se:umu:diva-217748 (URN)
Note

A brief background and overview are provided of the field of Swedish assessment and treatment for risky and severe substance use. The research projects whose results are presented in this issue have arisen from this understanding. The abbreviations EPI and ESTR are also explained. There are a series of answers to the question in the title. The most common answer is that a general increase in ambition would be needed, which in turn require more resources. Another answer is a need to clarify which organization is responsible for addiction treatment. A joint headship with the health care responsible for treatment in case of addiction and substance dependence was put forward in 2011, which did not happen. A renewed inquiry suggests the same thing. How it will turn out remains to be seen. Quite independently of reforms, there are opportunities for quality improvements by planning and following up the efforts offered to users in a systematic way

Available from: 2023-12-12 Created: 2023-12-12 Last updated: 2023-12-12Bibliographically approved
Hadding, C., Semb, O., Lehti, A., Martin, F., Sandlund, M. & DeMarinis, V. (2023). Being in-between; exploring former cult members' experiences of an acculturation process using the cultural formulation interview (DSM-5). Frontiers in Psychiatry, 14, Article ID 1142189.
Open this publication in new window or tab >>Being in-between; exploring former cult members' experiences of an acculturation process using the cultural formulation interview (DSM-5)
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2023 (English)In: Frontiers in Psychiatry, E-ISSN 1664-0640, Vol. 14, article id 1142189Article in journal (Refereed) Published
Abstract [en]

Objective: To explore the experiences of acculturation into secular Swedish society of former members of cults, with particular focus on mental health, needs and resources.

Design: Qualitative method using the Cultural Formulation Interview (CFI) from the DSM-5 as an interview guide. Analysis of participants’ experiences of acculturation through systematic text condensation.

Participants: Eleven Swedish former members of ideological or religion-based cults.

Setting: Swedish mainstream, secular society.

Results: Former cult members experience an ‘in-between time’ in the period after leaving the cult and find themselves in a confusing, chaotic state. They describe having lived in an honor culture where acts of violence were normalized. In the cult, they felt disconnected from themselves, and post-cult they try to regain access to their own values and feelings as well as create new bonds with family members and friends outside the cult. They find it hard to talk about their cult background and find relief in communicating with other former cult members. In their post-cult life, they eventually start seeing the world in a brighter, more hopeful way than before. However, they are also at risk of re-experiencing cult-related traumatic events and of new traumatic experiences within the post-cult acculturation process, and of persistent psychological distress.

Conclusion: Former cult members face a challenging acculturation process, having lost a functioning worldview upon leaving the cult but not yet gained another to take its place. While the in-between time is often transient, they may need support from the healthcare system, especially regarding mental health concerns, while establishing themselves into mainstream society.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2023
Keywords
acculturation, coersive control, consultation, cult, cultural formulation
National Category
Human Computer Interaction
Identifiers
urn:nbn:se:umu:diva-215230 (URN)10.3389/fpsyt.2023.1142189 (DOI)001074809100001 ()37779627 (PubMedID)2-s2.0-85172988375 (Scopus ID)
Available from: 2023-10-17 Created: 2023-10-17 Last updated: 2024-07-02Bibliographically approved
Lundgren, L., Jemberie, W. B. & Sandlund, M. (2023). Biopsykosocialt perspektiv och implementeringsteori. In: Lena Lundgren (Ed.), Effektiv insatsplanering vid svår substansanvändning: (pp. 43-58). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Biopsykosocialt perspektiv och implementeringsteori
2023 (Swedish)In: Effektiv insatsplanering vid svår substansanvändning / [ed] Lena Lundgren, Lund: Studentlitteratur AB, 2023, p. 43-58Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2023
National Category
Social Work
Research subject
medical behavioral science; Psychiatry; Social Medicine
Identifiers
urn:nbn:se:umu:diva-212577 (URN)9789144155180 (ISBN)
Available from: 2023-08-06 Created: 2023-08-06 Last updated: 2023-10-20Bibliographically approved
Sandlund, M. (2023). Evidensbaserad praktik, integrerade vårdinsatser och samsjuklighet. In: Lena Lundgren (Ed.), Effektiv insatsplanering vid svår substansanvändning: (pp. 59-75). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Evidensbaserad praktik, integrerade vårdinsatser och samsjuklighet
2023 (Swedish)In: Effektiv insatsplanering vid svår substansanvändning / [ed] Lena Lundgren, Lund: Studentlitteratur AB, 2023, p. 59-75Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2023
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-222834 (URN)9789144155180 (ISBN)
Available from: 2024-03-28 Created: 2024-03-28 Last updated: 2024-04-03Bibliographically approved
Scarpa, S., Grahn, R., Nyström, S., Sandlund, M. & Lundgren, L. (2023). Hur fungerade kursen Effektiv Planering av Insatser/EPI: Baslinje- och uppföljningsresultat. Socialmedicinsk Tidskrift, 100(5), 655-665
Open this publication in new window or tab >>Hur fungerade kursen Effektiv Planering av Insatser/EPI: Baslinje- och uppföljningsresultat
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2023 (Swedish)In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 100, no 5, p. 655-665Article in journal (Other (popular science, discussion, etc.)) Published
Abstract [sv]

Denna kvantitativa studie utvärderar kunskapsförändringar hos deltagare i EPI universitetskursen. Majoriteten av deltagarna var socialsekreterare inom miss-bruksområdet. Kursen resulterade i betydande förbättringar av deltagarnas kunskap, särskilt vad gäller insats- och vårdkontinuitetsmodeller samt använd-ning av motivationshöjande intervjutekniker. Kunskapen om äldre personer med beroendeproblem och fördelarna med ASI-uppföljningar för socialarbe-tare och klienter förbättrades också.

Abstract [en]

This quantitative study assesses knowledge improvement among partici-pants of the EPI university course. The majority were social workers in sub-stance abuse. The course led to significant enhancements in participants’ knowledge, particularly concerning intervention and care continuity and the use of motivational interview techniques. Knowledge about older individuals with substance dependencies and benefits of ASI follow-up interviews for social workers and clients also improved.

Keywords
Pre-post design, Educational intervention, Social work, Addiction
National Category
Social Work
Research subject
Social Medicine
Identifiers
urn:nbn:se:umu:diva-217749 (URN)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2019-01453
Available from: 2023-12-12 Created: 2023-12-12 Last updated: 2023-12-12Bibliographically approved
Sandlund, M. & Lundgren, L. (2023). Missbruk och missbruksvård. In: Lena Lundgren (Ed.), Effektiv insatsplanering: vid svår substansanvändning (pp. 29-41). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Missbruk och missbruksvård
2023 (Swedish)In: Effektiv insatsplanering: vid svår substansanvändning / [ed] Lena Lundgren, Lund: Studentlitteratur AB, 2023, p. 29-41Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2023
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-222833 (URN)9789144155180 (ISBN)
Available from: 2024-03-28 Created: 2024-03-28 Last updated: 2024-03-28Bibliographically approved
Bendtsen Kronkvist, M., Dahlqvist Jönsson, P., Forsberg, K.-A. & Sandlund, M. (2023). Service user participation in decision-making: a qualitative study from a services user’s perspective. Journal of Public Mental Health, 22(4), 157-169
Open this publication in new window or tab >>Service user participation in decision-making: a qualitative study from a services user’s perspective
2023 (English)In: Journal of Public Mental Health, ISSN 1746-5729, E-ISSN 2042-8731, Vol. 22, no 4, p. 157-169Article in journal (Refereed) Published
Abstract [en]

Purpose: The purpose of this study is to describe participation in decision-making among service users with severe mental illness.

Design/methodology/approach: Service users want to participate in decision-making and in the planning of their care. There are widely known methods, such as shared decision-making, that could be used to facilitate service user participation. Three focus group interviews were conducted with the participation of 14 persons with mental illness and/or substance abuse who were service users at two Swedish Homes for Care and Residence (HVB). Data were analyzed by qualitative content analysis.

Findings: Two themes emerged: service users’ involvement in decisions is hampered by the professionals’ approach and adequate information and experience of participation means greater empowerment.

Research limitations/implications: Although it is known that service users would like to have more influence, and that methods like shared decision-making are recommended to empower service users and improve the decision process, research on these matters is limited.

Practical implications: This study reveals that there is a need of more systematic decisional support, such as shared decision-making, so that service users can be seen as important persons not only in guidelines and policy documents but also in clinical practice.

Social implications: The findings indicate that service users do not participate in decisions systematically, although policies, guidelines and laws providing that service users should be offered an active part in decision-making with regard to their care and treatment.

Originality/value: Although it is known that service users would like to have more influence, and that methods like shared decision-making are recommended to empower service users and improve their decision process, research on these matters is limited. The findings indicate that service users do not participate in decisions systematically, even though policies, guidelines and laws are in place stipulating that service users should be offered an active part in decision-making with regard to their own care and treatment. The results of this project bring improvement opportunities to light.

Place, publisher, year, edition, pages
Emerald Group Publishing Limited, 2023
Keywords
Mental health, Recovery, Shared decision-making, User participation
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-212486 (URN)10.1108/JPMH-12-2022-0129 (DOI)001032543900001 ()2-s2.0-85165557193 (Scopus ID)
Available from: 2023-08-01 Created: 2023-08-01 Last updated: 2024-01-08Bibliographically approved
Lynøe, N., Lindblad, A., Engström, I., Sandlund, M. & Juth, N. (2023). Values at stake at the end of life: analyses of personal preferences among Swedish physicians. Clinical Ethics, 18(2), 239-244
Open this publication in new window or tab >>Values at stake at the end of life: analyses of personal preferences among Swedish physicians
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2023 (English)In: Clinical Ethics, ISSN 1477-7509, E-ISSN 1758-101X, Vol. 18, no 2, p. 239-244Article in journal (Refereed) Published
Abstract [en]

Background: Physician-assisted suicide is a controversial issue and has sometimes raised emotion-laden reactions. Against this backdrop, we have analyzed how Swedish physicians are reasoning about physician-assisted suicide if it were to be legalized. Methods and participants: We conducted a cross-sectional study and analyzed 819 randomly selected physicians’ responses from general practitioners, geriatricians, internists, oncologists, psychiatrists, surgeons, and all palliativists. Apart from the main questions about their attitude toward physician-assisted suicide, we also asked what would happen with the respondents’ own trust in healthcare if physician-assisted suicide were legalized. Response options were that trust would decrease, not be influenced, or would increase. Results: We identified a strong statistical association between on the one hand those whose own trust would increase and who were pro physician-assisted suicide, and on the other hand those who were against physician-assisted suicide and whose own trust would decrease [relative risk: 16.7 (95% confidence interval: 10.2–27.2)]. Among those whose own trust would not be influenced (n = 456), 60% were pro pysician-assisted suicide, 16% were against, and 24% were undecided. Of those whose trust would increase or not be influenced, a large majority supported autonomy-based arguments, whereas those whose trust would decrease supported non-maleficence-based arguments. Conclusion: Analyzing the answers after having divided respondents into those whose own trust in healthcare would decrease or increase and not be influenced brings about interesting results such as how the three groups prioritize arguments for and against physician-assisted suicide. This way of analyzing the data seems to be a promising strategy when identifying value-impregnated factual claims.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
Personal values, physician-assisted suicide, trust in healthcare, value-impregnated factual claims
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-192793 (URN)10.1177/14777509221077387 (DOI)2-s2.0-85124878054 (Scopus ID)
Available from: 2022-03-01 Created: 2022-03-01 Last updated: 2023-07-14Bibliographically approved
Lieber, I., Ott, M., Lundqvist, R., Eliasson, M., Sandlund, M. & Werneke, U. (2022). Elevated Thyroxine Concentration and Lithium Intoxication - An Analysis Based on the LiSIE Retrospective Cohort Study. Journal of Clinical Medicine, 11(11), Article ID 3041.
Open this publication in new window or tab >>Elevated Thyroxine Concentration and Lithium Intoxication - An Analysis Based on the LiSIE Retrospective Cohort Study
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2022 (English)In: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 11, no 11, article id 3041Article in journal (Refereed) Published
Abstract [en]

(1) Background: It has been suggested that hyperthyroxinaemia is a risk factor for lithium intoxication by altering tubular renal function. (2) Methods: We determined the relevance of hyperthyroxinaemia as a risk factor for lithium intoxication in patients with bipolar or schizoaffective disorder in the framework of the LiSIE (Lithium-Study into Effects and Side Effects) retrospective cohort study. Of 1562 patients included in the study, 897 patients had been exposed to lithium at any time between 1997 and 2017 with 6684 person-years of observation. (3) Results: There were 65 episodes of unintentional lithium intoxication in 53 patients. There were nine episodes with hyperthyroxinaemia at the time of lithium intoxication, yielding an incidence of 1.3 episodes/1000 person-years. For all nine episodes, we could identify alternative, more plausible, explanations for the observed lithium intoxications. (4) Conclusions: We conclude that hyperthyroxinaemia-associated unintentional lithium intoxication is an uncommon event. A direct causal link between hyperthyroxinaemia and altered tubular renal function remains elusive. Increasing the frequency of routine thyroid function tests seems unlikely to decrease the risk of lithium intoxication.

Place, publisher, year, edition, pages
MDPI, 2022
Keywords
hyperthyroxinaemia, hyperthyroidism, thyroxine, lithium, intoxication, bipolar disorder, schizoaffective disorder, thyroid disorder
National Category
Psychiatry Endocrinology and Diabetes Pharmacology and Toxicology
Identifiers
urn:nbn:se:umu:diva-199132 (URN)10.3390/jcm11113041 (DOI)000809003400001 ()35683429 (PubMedID)2-s2.0-85130738317 (Scopus ID)
Funder
Norrbotten County CouncilVisare Norr, 847881Visare Norr, 939391
Available from: 2022-09-05 Created: 2022-09-05 Last updated: 2023-05-23Bibliographically approved
Lundgren, L., Padyab, M., Sandlund, M. & McCarty, D. (2022). Frequency and recency of non-medical opioid use and death due tooverdose or suicide among individuals assessed for risky substance use: Anational registry study in Sweden. Journal of Substance Abuse Treatment, Article ID 108567.
Open this publication in new window or tab >>Frequency and recency of non-medical opioid use and death due tooverdose or suicide among individuals assessed for risky substance use: Anational registry study in Sweden
2022 (English)In: Journal of Substance Abuse Treatment, ISSN 0740-5472, E-ISSN 1873-6483, article id 108567Article in journal (Refereed) Published
Abstract [en]

Sweden and many other countries have experienced increases in suicide and accidental overdose deaths. Ananalysis examined the associations between recency of non-medical opioid misuse and frequency of use of nonmedicalopioids with death due to either suicide or accidental overdose within a sample of 15,000 Swedish adultswho completed an Addiction Severity Index (ASI) assessment for risky substance use or a substance use disorder.Methods and materials: Suicide (n = 136) and death due to overdose (n = 405) were identified in the official Causeof Death Registry from the Swedish National Board of Health and Welfare. Control variables included demographiccharacteristics and risks associated with either overdose or suicide. Cox regression analyses controlledfor variables statistically significantly at the bivariate level.Results: At the multivariable level: a) a higher (modified) ASI Composite Score for mental health; b) history ofsuicide attempt; c) having used non-medical opioids for 1–2 times per week for at least a year; d) history ofinjection drug use; and, e) early onset of drug use, were all significantly and positively associated with death dueto suicide. At the multivariable level: a) a higher the revised ASI Composite Score for mental health; b) recency ofuse of non-medical opioids; c) frequency of non-medical opioid use; d) being a male; and e) being of ages 18–24years compared to ages 43–51 years were all positively and significantly associated with death due to accidentaloverdose.Conclusion: These findings underscore the need to integrate mental health and substance use disorder treatmentand provide suicide and overdose prevention interventions for individuals with an opioid use disorder. Recencyand frequency of non-medical opioids were only associated with death due to overdose and not suicide. However,other drug use related variables (using opioids 1–2 times per week for at least a year, early onset of drug use anddrug injection) were significantly associated with death due to suicide.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Overdose, Suicide, Mortality, Opioid use, Sweden
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-190495 (URN)10.1016/j.jsat.2021.108567 (DOI)000789151900009 ()34340844 (PubMedID)2-s2.0-85111594396 (Scopus ID)
Projects
STANCE-programmet: Studier av socialtjänstens interventioner för alkohol- och narkotikaproblem och hälsoeffekter, ett kollaboralt longitudinellt forskningsprogram
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-07213
Available from: 2021-12-16 Created: 2021-12-16 Last updated: 2023-09-05Bibliographically approved
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