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  • 1.
    Birkeland, Anna-Lena
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Dahlgren, Lars
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Hägglöf, Bruno
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Child and Adolescent Psychiatry.
    Rydberg, Annika
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Breaking bad news: an interview study of paediatric cardiologists2011In: Cardiology in the Young, ISSN 1047-9511, E-ISSN 1467-1107, Vol. 21, no 3, p. 286-291Article in journal (Refereed)
    Abstract [en]

    Technical developments in paediatric cardiology over the last few decades have increased expectations on professionals, demanding of them more emotional competence and communicative ability. The aim of this study was to examine the approach of paediatric cardiologists in informing and communicating with the family of the patient.

    Method: A qualitative interview method was first tested in a pilot study with two paediatric cardiologists. There were nine subsequent semi-structured interviews that were carried out with paediatric cardiologists. A researcher performed all the interviews, which were taped, transcribed, decoded, and analysed.

    Results: Among paediatric cardiologists, how to break bad news to the family is an important concern, evident in findings regarding the significance of trust and confidence, the use of different emotional positions, and a common ambition to achieve skills to handle the situation. There is a need for reflection, education, and sharing of experiences. The cardiologists desire further development of teamwork and of skills in medical students and residents for delivering bad news.

    Conclusions: Doctors are expected to cope with the complexities of diagnoses and decisions, while simultaneously being sensitive to the feelings of the parents, aware of their own emotions, and able to keep it all under control in the context of breaking the bad news to the parents and keeping them informed. These conflicting demands create a need to expand the professional role of the doctor by including more training in emotional competence and communicative ability, beginning in medical school and continuing through consultancy.

  • 2.
    Birkeland, Anna-Lena
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Hagglöf, Bruno
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Child and Adolescent Psychiatry.
    Dahlgren, Lars
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Rydberg, Annika
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Interprofessional teamwork in Swedish pediatric cardiology: a national exploratory study2013In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 27, no 4, p. 320-325Article in journal (Refereed)
    Abstract [en]

    This paper aims to describe the nature of pediatric cardiology teams (PCTs) based in Sweden through the use of a mixed methods approach. Questionnaires examining issues about the organization/ways of working, functions/tasks and attitudes were answered by 30 PCTs. Focus group interviews were conducted with six PCTs, selected purposefully by size and location, and information on experiences and attitudes on interprofessional teamwork was explored in depth. Results from the quantitative indicated that in 17 of the teams, where the nurse acted as the central coordinator, there was a positive attitude to the value of teamwork. In the interviews, different problems and needs of improvements were mentioned regarding structure, leadership, presence of physicians in the team as well as the team's mandate. All of the participants, however, agreed that interprofessional teams were required to manage the complexity of the children's care. In conclusion, this study suggests that PCTs need further support to develop structure, leadership and coordination of resources to function in a more effective manner. National plans or recommendations that mandate the organization and working methods of PCTs would be helpful for the ongoing development of PCTs in Sweden.

  • 3.
    Birkeland, Anna-Lena
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Hällgren Graneheim, Ulla
    Umeå University, Faculty of Medicine, Department of Nursing.
    Rydberg, Annika
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Hägglöf, Bruno
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Child and Adolescent Psychiatry.
    Dahlgren, Lars
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Facing bad news: a case study focusing on families having a child with congenital heart diseaseManuscript (preprint) (Other academic)
  • 4.
    Birkeland, Anna-Lena
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Rydberg, Annika
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Dahlgren, Lars
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Hägglöf, Bruno
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Child and Adolescent Psychiatry.
    Teamwork in Swedish paediatric cardiology: a national exploratory study examining function and dynamicsManuscript (preprint) (Other academic)
  • 5.
    Brännström, Inger
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Emmelin, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Dahlgren, Lars
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Johansson, Martin
    Wall, Stig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Co-operation, participation and conflicts faced in public health: lessons learned from a long-term prevention programme in Sweden1994In: Health Education Research, ISSN 0268-1153, E-ISSN 1465-3648, Vol. 9, no 3, p. 317-329Article in journal (Refereed)
    Abstract [en]

    A comprehensive community-based programme for prevention of cardiovascular diseases (CVD) and diabetes was established in 1985 in a small municipality in northern Sweden. A cross-sectional survey to the general public was performed and semi-structured open-ended interviews were taken of actors at different levels. Notes from official records were also included in the study. The aim was to describe and discuss some factors that promote or constrain community participation in health programmes. The results generally confirmed that the right of definition concerning the health programme mainly remained with the health professionals. Community participation was mainly defined by the actors based on the medical and health planning approach and, thereby, as a means to transform health policy plans into reality by transmitting health knowledge and increasing consciousness among the citizens of the need for changing lifestyles. However, participation as a means of identifying problems and demonstrating power relationships and as elements in promoting local democracy was hardly represented among the actors at all. Overall, the CVD health programme was characterized by consensus between the actors. Despite this, debates and arguments about interpretations, social interests, personal conflicts and ideological constraints were observed. However, a majority of the public wanted the CVD preventive programme to continue.

  • 6.
    Dahlblom, Kjerstin
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Herrera Rodríguez, Andrés
    Peña, Rodolfo
    Dahlgren, Lars
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Home alone: children as caretakers in León, Nicaragua2009In: Children and society, ISSN 0951-0605, Vol. 23, no 1, p. 43-56Article in journal (Refereed)
    Abstract [en]

    This article seeks to explore and understand the life situations of sibling caretakers in poor areas in León, Nicaragua. The every day lives for caretakers were studied through observations and interviews with children, informants and parents. The children themselves were satisfied and proud to be trusted as caretakers and felt useful in contributing to their families' livelihood. However, in a life course perspective the caretaking role implies a narrowing of life options. Early on they seem to acquire essential life skills but as they grow older many are at risk of falling behind due to their marginalised situation and lack of basic education.

  • 7.
    Dahlgren, Lars
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Samhällsplanering och lokalsamhälle: en sociologisk analys av den sociala samhällsplaneringens möjligheter och begränsningar, illustrerad av tre ortsstudier i Norrbottens län1984Doctoral thesis, monograph (Other academic)
    Abstract [en]

    The purpose of this dissertation is to make a contribution to the creation of more efficient social planning. It has been formulated in the following way: 1. To describe how social planning has developed in Sweden and what role sociological knowledge has played in this process. 2. To analyse thè social causes of this development. 3. To illustrate the development of our society througt the study of three communities in the county of Norrbotten. These empirical studies serve a double purpose. They are examples of the kind of planning-tools for which this dissertation argues. They are also meant to throw a light on the specific social evolution, which has created different forms and contents in the planning process. A tangible starting point for the dissertation is to establish the fact that social planning has expanded rapidly after the inter-war pe-riod-both in form and substance and the development is characterized by centralisation and division into sectors. In other words, it is distinguished by increased vertical and horizontal division of labour. During the seventies, however, a growing criticism of this process was articulated, particularly from two directions: agencies in the social sector and districts in the periphery-areas which begin to experience the consequences of structural rationalisation. Among other things they want more social and qualitative planning to take place. An increasing interest in sociological knowledge can be seen as a response to this criticism. After that three normative possibilities of development is presentated on the assumption that social planning for the time being is characterized by centralisation as well as division into sectors. The argumentation aims to show how one of the normative possibilities, a co-ordination between de-centralization and a reduced division into sectors, can make public planning more effective. Furthermore two aspects of the^efficiency problem are discussed. The first perspective is based on productivity and deals with the question to what extent social planning activities are producing optimum knowledge from investigated resources. The other perspective focuses on the ability of social planning to help citizens form an opinion of political decisions. This discussion is a theoretical background to the normative recommendations for planning methods (community studies as a complement to social planning)which follows. The planning methods are illustraded by three community studies carried out in Korpilombolo, Seskarb and Rosvik, all three communities in the most northern county of Sweden, Norrbotten. The collection of data took place within the framework of the pilot project: Social development planning in the county of Norrbotten. The theoretical frame of reference of these studies is based on the concept 'Way of Life', which is defined as the totality of peoples' destinies, activities,everyday life and relationsship. The way of life in the three villages is outlined and compared in three dimensions, activities, needs and resources. Finally future studies following on from this dissertation is suggested, for instance, 'ex-post' estimates regarding actual consequences of applied com-munity studies.

  • 8.
    Dahlgren, Lars
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Emmelin, Maria
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Winkvist, Anna
    Qualitative methodology for international public health2007Book (Other academic)
  • 9.
    Dahlgren, Lars
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Starrin, Bengt
    Emotioner, vardagsliv & samhälle : en introduktion till emotionssociologi2004Book (Other academic)
  • 10.
    Dapi N., Léonie
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Janlert, Urban
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Omoloko, Cécile
    Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
    Dahlgren, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Social Sciences, Department of Sociology.
    Håglin, Lena
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    "I eat to be happy, to be strong, and to live": perceptions of rural and urban adolescents in Cameroon, Africa2007In: Journal of nutrition education and behavior, ISSN 1499-4046, E-ISSN 1878-2620, Vol. 39, no 6, p. 320-326Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate factors influencing rural and urban adolescents’ food perceptions during a time of nutritional transition in Cameroon, Africa.

    Design: Qualitative in-depth interviews.

    Settings: Yaoundé urban and Bandja rural areas.

    Participants: Fifteen adolescents 12 to 15 years old purposely selected from schools in urban and rural areas.

    Analysis: Interviews were audiotaped, transcribed, and analyzed using Grounded Theory method.

    Findings: Factors influencing adolescents’ food perceptions from the rural area were “to live” “health” and “poverty.” Among adolescents from the urban poor area, “health,” “beauty,” and “not enough money” were factors. Among adolescents from the urban rich area, “pleasure” and “beauty” were factors. Rural girls liked “to be fat,” whereas girls from the urban poor wanted “to be a little bit fat,” and girls from the urban rich wanted “to be normal.”

    Conclusions and Implications: Food behavior is changing from a diet composed of traditional food in rural areas to a more westernized diet in urban areas. The relationship between socioeconomic factors and nutrition needs to be examined with a sufficiently large number of adolescents to investigate these factors in a quantitative survey. Healthful local food should be available at home and from vendors. Nutrition education about food and diet-related diseases is needed in school.

  • 11.
    Edin, Kerstin
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Dahlgren, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Högberg, Ulf
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    The pregnancy put the screws on: discourses of professionals working with men inclined to violence2009In: Men and Masculinities, ISSN 1097-184X, E-ISSN 1552-6828, Vol. 11, no 3, p. 307-324Article in journal (Refereed)
    Abstract [en]

    Qualitative research interviews were conducted with professionals working with men inclined to violence. The aim was to explore professional discourses about intimate partner violence with special reference to gender and to the partner's period of pregnancy. Three major findings are presented. Firstly, the professionals had a rather fixed understanding of opposite gender positions as well as a split picture of the violent man as both weak and tough, thus violence may result from poor self-confidence combined with a desire for power and control and the fear of losing it. Secondly, the pregnancy was identified as a stressor that, together with other circumstances, could trigger violence. Thirdly, the topic of pregnancy and other relational topics were typically omitted from the conversations with men inclined to violence. This study discusses inconsistencies that might counteract the professionals' intentions of building an alternative masculinity in men inclined to violence.

  • 12.
    Edin, Kerstin
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Dahlgren, Lars
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Högberg, Ulf
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    "Keeping up a front": narratives about intimate partner violence, pregnancy, and antenatal care2010In: Violence against Women, ISSN 1077-8012, E-ISSN 1552-8448, Vol. 16, no 2, p. 189-206Article in journal (Refereed)
    Abstract [en]

    Nine women who had been subjected to severe intimate partner violence during pregnancy narrated their ambiguous and contradictory feelings and the various balancing strategies they used to overcome their complex and difficult situations. Because allowing anyone to come close posed a threat, the women mostly denied the situation and kept up a front to hide the violence from others. Three women disclosed ongoing violence to the midwives, but only one said such disclosure was helpful. This article highlights the complexity of being pregnant when living with an abusive partner and challenges antenatal care policies from the perspective of pregnant women.

  • 13.
    Edin, Kerstin
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Högberg, Ulf
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Dahlgren, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Violent men: ordinary and deviant.2008In: Journal of Interpersonal Violence, ISSN 0886-2605, E-ISSN 1552-6518, Vol. 23, no 2, p. 225-244Article in journal (Refereed)
  • 14.
    Edlund, Curt
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Dahlgren, Lars
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    The physician's role in the vocational rehabilitation process2002In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 24, no 14, p. 727-733Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To describe and analyse physicians' experiences of working with sick-listing and vocational rehabilitation, their perceptions of their co-actors and the interaction they participate in.

    METHOD: Thematic interviews with 14 physicians in Västerbotten County, northern Sweden. The physicians were active in primary or occupational health care, or as hospital doctors. The interviews were conducted during the autumn of 1996. The interviews were tape recorded and analysed according to Grounded theory.

    RESULTS: Feelings of isolation and diminished control, lack of time and increased demands are all seen as obstacles for doing an optimal job with sick-listing and rehabilitation. Other obstacles are insufficient knowledge regarding the labour market and the social insurance legislation. Interaction between primary and in-patient care does not function satisfactorily. The doctors believe in their patients and a majority of the doctors feel that the patients' own understanding of/need for sick-listing guides the doctor in his or her position regarding sick-listing. To facilitate return to work, the doctors encourage part-time sick-listing.

    CONCLUSIONS: The interviews show that the physicians experience a growing discrepancy between ideal and reality. They want to be able to act as "team players", but experience increasing demands due to the increased number of patients who are sicker than before. The doctors experience that decision latitude has diminished and this has been followed by less time for patients.

  • 15.
    Emmelin, Maria
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Lindholm, Lars
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Dahlgren, Lars
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Pol-ethical considerations in public health.: The views of Swedish health care politicians1999In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 9, no 2, p. 124-130Article in journal (Refereed)
    Abstract [en]

    Background: Public health policy is often concerned with the conflicting values emanating from the individually formulated ethics for curative care and more collectively oriented ethics. In this study we have focused on the pol-ethical considerations involved in Swedish health care politicians' assessment of public health measures. Methods: We described a hypothetical situation in a questionnaire, where a community has a 50% excess mortality for disease X, compared to the national average. Scientific disagreements were identified and discussed. The respondents gave their preference for a specific intervention strategy and considered, on a graded scale, 17 different value statements related to ethical principles and intervention strategies. Results: Only one out of 451 politicians preferred the alternative ‘no intervention’. The majority preferred an intervention including active involvement of primary health care. There was overall strong support for equity and beneficence. A factor analysis gave a model for the association between ethical values, political affiliation and choice of intervention strategies. The relative weights of autonomy and equity were strongly related to political affiliation. Conclusions: Among Swedish health care politicians there is consensus about the value of performing interventions in public health when the problem is large, even if there is some uncertainty about the consequences. Their overall strong support for equity and beneficence implies that these principles are crucial when formulating policies for interventions. Politicians need to state their ethical standpoint explicitly so that we as citizens can judge their decisions and actions based on our own political ideology and support for basic ethical principles.

  • 16.
    Emmelin, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Stegmayr, Birgitta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Dahlgren, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Wall, Stig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Self-rated ill-health strengthens the effect of biomedical risk factors in predicting stroke especially for men: An incident case referent study2003In: Journal of Hypertension, ISSN 0263-6352, E-ISSN 1473-5598, Vol. 21, no 5, p. 887-896Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To examine how self-rated ill-health interacts with biomedical stroke risk factors in predicting stroke and to explore differences between men and women and educational groups. DESIGN: An incident case-referent study where the study subjects had participated in a prior health survey. SETTING: Nested within the Västerbotten Intervention Program (VIP) and the Northern Sweden MONICA cohorts. SUBJECTS: The 473 stroke cases had two referents per case, matched for age, sex and residence, from the same study cohorts. RESULTS: Self-rated ill-health independently increased the risk of stroke, specifically for men. The interaction effect between self-rated health and biomedical risk factor load was greater for men than for women. The attributable proportion due to interaction between having a risk factor load of 2+ and self-rated ill-health was 42% for men and 15% for women. Better-educated individuals with self-rated ill-health and two or more of the biomedical risk factors had a higher risk of stroke than the less educated. Calculations of the respective contribution to the stroke cases of self-rated health, hypertension and smoking showed that self-rated ill-health had a role in 20% of the cases and could alone explain more than one-third of the cases among those who rated their health as bad, more so for men than for women. CONCLUSIONS: The results underscore the importance of including both a gender and a social perspective in discussing the role of self-rated health as a predictor of disease outcome. Physicians must be more gender sensitive when discussing their patient's own evaluation of health in relation to biomedical risk factors.

  • 17.
    Emmelin, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Wall, Stig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Dahlgren, Lars
    Umeå University, Faculty of Social Sciences, Department of Sociology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    To be seen, confirmed and involved - a ten year follow-up of perceived health and cardiovascular risk factors in a Swedish community intervention programme2007In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 7, p. 190-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Public health interventions are directed towards social systems and it is difficult to foresee all consequences. While targeted outcomes may be positively influenced, interventions may at worst be counterproductive. To include self-reported health in an evaluation is one way of addressing possible side-effects. This study is based on a 10 year follow-up of a cardiovascular community intervention programme in northern Sweden. METHODS: Both quantitative and qualitative approaches were used to address the interaction between changes in self-rated health and risk factor load. Qualitative interviews contributed to an analysis of how the outcome was influenced by health related norms and attitudes. RESULTS: Most people maintained a low risk factor load and a positive perception of health. However, more people improved than deteriorated their situation regarding both perceived health and risk factor load. "Ideal types" of attitude sets towards the programme, generated from the interviews, helped to interpret an observed polarisation for men and the lower educated. CONCLUSION: Our observation of a socially and gender differentiated intervention effect suggests a need to test new intervention strategies. Future community interventions may benefit from targeting more directly those who in combination with high risk factor load perceive their health as bad and to make all participants feel seen, confirmed and involved.

  • 18.
    Eriksson, Malin
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Department of Social Work.
    Dahlgren, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Department of Sociology.
    Emmelin, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Understanding the role of social capital for health promotion beyond Putnam: a qualitative case study from northern Sweden2009In: Social theory and health, ISSN 1477-8211, Vol. 7, no 4, p. 318-338Article in journal (Refereed)
    Abstract [en]

    Social capital is believed to improve the capacity of communities to work together for solving collective health problems. The present study was conducted in a community in northern Sweden where citizens through collective actions managed to build an association-driven health center. The aims were to describe the community's existing social capital in order to explore how Putnam's theories could contribute to an understanding of the observed high civic engagement and to discuss how other theoretical perspectives might add to an understanding of the role of social capital for health promotion. A qualitative case study was performed and the analysis followed a grounded theory approach. In accordance with Putnam, inherited social capital and high participation in existing associations were found to be important for uniting people. Beyond these, other aspects such as effective information channels, strong leaders and high social control were also significant and better understood by adding Coleman's and Bourdieu's views of social capital. If social capital is to be used for the purposes of health promotion the risk of increased social inequality as an unintended consequence needs to be considered. An awareness of how specific contextual conditions affect the building and mobilizing of social capital is also crucial.

  • 19.
    Falkdal Hansen, Annie
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Occupational Therapy.
    Edlund, Curt
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Dahlgren, Lars
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Social Sciences, Department of Sociology.
    Experiences within the process of sick leave.2006In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 13, no 3, p. 170-182Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore what individuals who have been on sick leave experienced as important in the process of returning to work, moving to long-term sick leave, or receiving a disability pension. Grounded Theory was used for interpreting interviews with 15 people who had been on sick leave four years previously. In the results four ideal types were crystallized which are presented in the form of vignettes. The ideal types were discussed focusing on occupational life using the Model of Human Occupation and the theories of Sense of Coherence and Status Passage. The study provided a deeper understanding of people's experiences during the process of their sick leave. Valuable predictors for re-entry into work or disability retirement were: individual mental resources; clear or unclear diagnosis; how long had been spent in the sick-leave process; and personal belief in an ability to work in the future. The interventions and support given by professionals and the social environment, the balance and sense of coherence in life, and participation in the sick leave process were also important. The idealtypes found could be helpful to professionals working in this field in deepening their understanding of the clients.

  • 20.
    Gustafsson-Larsson, Susanne
    et al.
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine.
    Thurén, Britt-Marie
    Dahlgren, Lars
    Faculty of Social Sciences, Sociology.
    Westman, Göran
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine.
    Bun-baking mums and subverters: The agency of network participants in a Rural Swedish county2007In: Women´s Studies International Forum, Vol. 30, p. 48-58Article in journal (Refereed)
  • 21.
    Herrera Rodríguez, Andrés
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Dahlblom, Kjerstin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Dahlgren, Lars
    Umeå University, Faculty of Social Sciences, Department of Sociology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Kullgren, Gunnar
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Pathways to suicidal behaviour among adolescent girls in Nicaragua2006In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 62, no 4, p. 805-814Article in journal (Refereed)
    Abstract [en]

    Adolescent girls are the most frequent suicide attempters worldwide. However, there is little knowledge about pathways leading to suicidal behaviour among young people, in particular in low-income countries. This study explores the motives and processes related to suicidal behaviour among young girls in Nicaragua. Individual in-depth interviews were conducted with eight girls aged between 12 and 19 admitted to hospital after attempting suicide. The audio-taped interviews lasted 2–4 h and were transcribed, translated into English and coded for content. Grounded theory and content analysis were used to construct a theory of the mechanisms behind their suicidal behaviour.

    A tentative model exploring pathways to suicidal behaviour is described with four main categories: structuring conditions, triggering events, emotions and actions taken. The model illustrates the dialectic interplay between structure and actions taken. Actions taken were categorized as problem solving or various forms of escape where failure with either of these strategies resulted in a suicide attempt.

    Dysfunctional families, absent fathers and lack of integration into society were some of the structuring conditions that lead to emotional distress. Abuse, deaths in the family, break-up with boyfriends or suicide among friends acted as triggering events. A striking finding was the obvious narrative competence of the girls.

    Our findings indicate that suicide prevention programmes for young people must offer support from professionals, independent of their family and social networks. Institutions in the community in contact with young people with suicidal behaviour must develop communicative skills to offer a trusting environment mobilising the resources that young people have.

  • 22. Källestål, Carina
    et al.
    Dahlgren, Lars
    Umeå University, Faculty of Social Sciences, Department of Sociology. Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Oral health behavior and self-esteem in Swedish adolescents over four years2006In: Journal of Adolescent Health, Vol. 38, no 5, p. 583-590Article in journal (Refereed)
  • 23.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Rönnlund, Ulla
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Dahlgren, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Umeå University, Faculty of Social Sciences, Department of Sociology.
    Veganism a status passage: the process of becoming a vegan among youths in Sweden2003In: Appetite, ISSN 0195-6663, E-ISSN 1095-8304, Vol. 41, no 1, p. 61-67Article in journal (Refereed)
    Abstract [en]

    In a town in northern Sweden, 3.3% of the 15-year-old adolescents were vegans in 1996. This study describes the process of becoming a vegan among adolescents and interprets the informants' descriptions by constructing categories, which later on were related to relevant theories. Group interviews were conducted with three vegans and in-depth interviews were performed with three other vegan adolescents. The methodology was grounded theory and the adolescents' perceptions were analyzed in the framework of symbolic interactionism. Three types of vegans were identified: the Conformed Vegan, the Organized Vegan, and the Individualistic Vegan. The decision to become a vegan was reported to be influenced by perceived internal reasons such as ethics, health, distaste for meat, and preference for vegetarian food. In addition, friends, family, school, media, and music influenced the decision to become a vegan. The perceived consequences of becoming a vegan were positive as well as negative and differed between the three types of vegans. Veganism as a new type of status passage with specific characteristics was illustrated. No modifications or new properties were discovered that add to the theory of status passage which indicates that the general model is applicable also in a vegan context.

  • 24.
    Larsson, Christel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Rönnlund, Ulla
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Dahlgren, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Veganism as status passage: the process of becoming a vegan among youths in Sweden2002In: Fourth International Congress on Vegetarian Nutrition, Loma Linda, USA., 2002Conference paper (Refereed)
  • 25.
    Lindström, Meta
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Wulff, Marianne
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Dahlgren, Lars
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Lalos, Ann
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Experiences of working with induced abortion: focus group discussions with gynaecologists and midwives/nurses2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 3, p. 542-548Article in journal (Refereed)
    Abstract [en]

    Background:  While there exists an extensive amount of research regarding the medical aspects of abortion, there is a great lack of studies investigating staff's views and experiences of working in abortion services.

    Aims:  To elucidate gynaecologists' and midwives'/nurses' experiences, perceptions and interactions working in abortion services, their experiences of medical abortions and abortions performed at the woman's home. An additional aim was to illustrate gynaecologists', midwives' and nurses' visions of their future professional roles within the abortion services.

    Method:  Three focus group discussions within each profession were carried out in 1-hour sessions with a total of 25 gynaecologists and 15 midwives/nurses from three different hospitals.

    Results:  The content analysis reflected that gynaecologists and midwives/nurses had no doubts about participating in abortions despite the fact that they had experienced complex and difficult situations, such as repeat and late-term abortions. They experienced their work as paradoxical and frustrating but also as challenging and rewarding. However, they were rarely offered ongoing guidance and continuously professional development education. For gynaecologists, as well as midwives/nurses, their experiences and perceptions were strongly linked to the concurrent development of abortion methods. The interaction between the professions was found to be based on great trust in each other's skills.

    Conclusions:  In order to promote women's health, gynaecologists' and midwives'/nurses' need for a forum for reflection and ongoing guidance should be acted on. With a higher number of abortions done medically and a higher proportion of home abortions, midwives/nurses will get increased, responsibilities in the abortion services in the future.

  • 26. Lugalla, Joe
    et al.
    Emmelin, Maria
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Mutembei, Aldin
    Sima, Mwiru
    Kwesigabo, Gideon
    Killewo, Japhet
    Dahlgren, Lars
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Social, cultural and sexual behavioral determinants of observed decline in HIV infection trends: lessons from the Kagera Region, Tanzania.2004In: Soc Sci Med, ISSN 0277-9536, Vol. 59, no 1, p. 185-98Article in journal (Refereed)
  • 27.
    Lusey, Hendrew
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Medicine, Department of Nursing. World Council Churches, Ecumen HIV & AIDS Initiat Africa EHAIA, Kinshasa, DEM REP CONGO and .
    San Sebastian, Miguel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Christianson, Monica
    Umeå University, Faculty of Medicine, Department of Nursing.
    Dahlgren, Lars
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Edin, Kerstin E
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Department of Sociology. Umeå University, Faculty of Medicine, Department of Nursing.
    Conflicting discourses of church youths on masculinity and sexuality in the context of HIV in Kinshasa, Democratic Republic of Congo2014In: SAHARA-J: Journal of Social Aspects of HIV/AIDS, ISSN 1729-0376, E-ISSN 1813-4424, Vol. 11, no 1, p. 84-93Article in journal (Refereed)
    Abstract [en]

    Masculinity studies are fairly new and young churchgoers are an under-researched group in the current Congolese church context. In response to this knowledge gap, this paper attempts to explore discourses of young churchgoers from deprived areas of Kinshasa regarding masculinity and sexuality in the era of HIV. A series of 16 semi-structured interviews were conducted with unmarried young churchgoers from the Salvation Army, Protestant and Revival churches. The interviews were tape-recorded, transcribed verbatim and analysed using discourse analysis. Five main discourses emerged: 'we are aware of the church message on sex', 'young men need sex', 'young women need money', 'to use or not to use condoms' and 'we trust in the church message'. Although all informants knew and heard church messages against premarital sex, many of them were sexually active. The perception was that young men were engaged in sexual activities with multiple partners as a result of sexual motivations surrounding masculinity and sexual potency, while young women sought multiple partners through transactional and intergenerational sex for economic reasons. These sexual practices of young people conflicted with church messages on sexual abstinence and faithfulness. However, a small number of participants challenged current gender norms and suggested alternative ways of being a man or a woman. To elucidate these alternatives, we suggest that church youths and church leaders might take concrete actions to deconstruct misconceptions about being men. In this way, they can possibly enhance a frank and fruitful dialogue on sex, sexuality and gender to promote positive masculinities and constructive partnerships to prevent HIV.

  • 28.
    Mogren, Ingrid
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Winkvist, Anna
    Department of Metabolism and Cardiovascular Research/Clinical Nutrition, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
    Dahlgren, Lars
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Trust and ambivalence in midwives' views towards women developing pelvic pain during pregnancy: a qualitative study2010In: BMC public health, ISSN 1471-2458, Vol. 10, p. 600-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The Swedish midwife plays a significant role in the antenatal care (ANC) system, and a majority of pregnant women are satisfied with their ANC. Pelvic pain during pregnancy (PP) is prevalent. The study investigated the views, perceptions and attitudes of midwives currently working in ANC regarding PP during pregnancy.

    METHODS: The informants were ten midwives between the ages of 35 to 64 years, with a combined experience of 250 years of midwifery. In-depth interviews (n = 4) and one focus group discussion (n = 6) were conducted. The data were interpreted using a qualitative content analysis design.

    RESULTS: PP was considered a common, clinical problem that had most likely increased in prevalence in recent decades and could feature prominently in a woman's experience of pregnancy. The informants had developed a strategy for supporting pregnant women affected by PP. The pregnant woman's fear of not being believed concerning her symptoms and the risk of being regarded as a malingerer were acknowledged. Mistrust between a midwife and a woman might occur when the patient's symptoms were vague and ill defined. PP was not considered as something that complicated delivery, and women experiencing it were advised to await 'the natural course of the pregnancy'.

    CONCLUSIONS: PP was considered a common, clinical problem and the informants had developed a strategy for supporting pregnant women affected by PP. However, the woman's fear of not being believed concerning her symptoms of PP was acknowledged and mistrust might occur between a midwife and a woman if vague symptoms were reported.

  • 29.
    Nordström, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Kullgren, Gunnar
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Dahlgren, Lars
    Umeå University, Faculty of Social Sciences, Department of Sociology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Schizophrenia and violent crime: The experience of parents2006In: International Journal of Law and Psychiatry, ISSN 0160-2527, E-ISSN 1873-6386, Vol. 29, no 1, p. 57-67Article in journal (Refereed)
    Abstract [en]

    Individuals with schizophrenia have an increased risk of committing a violent crime, although their contribution to the overall criminality in society is small. In this qualitative study we have interviewed parents of adult sons, diagnosed with schizophrenia and who recently had been referred to forensic psychiatric treatment due to a violent crime, with an aim to explore the parents' experiences and emotional reactions. Four events, or status passages, emerged as crucial and common for all parents. These were the onset of the mental disorder, the diagnosis of schizophrenia, the violent behaviour/criminality and the recent referral to forensic psychiatric treatment. Every passage evoked strong emotional reactions such as guilt, fear, disappointment, anger and relief, which in return led to different actions taken. Unawareness of the character and severity of their sons' mental illness and the type of violent criminality they had committed were common and complicated contacts both between the parents and their sons, and also between family members and official authorities. The findings emphasize that psychiatric healthcare professionals must take the initiative and responsibility for information, education and support of family members.

  • 30.
    Obando Medina, Claudia
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Dahlblom, Kjerstin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Dahlgren, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Herrera, Andres
    Kullgren, Gunnar
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    I keep my problems to myself: pathways to suicide attempts in Nicaraguan young men2011In: Suicidology Online, ISSN 2078-5488, E-ISSN 2078-5488, Vol. 2, p. 17-28Article in journal (Refereed)
    Abstract [en]

    This qualitative study is an attempt to understand the pathways leading to attempted suicide of young men in León, Nicaragua. Our research is based on in-depth interviews with twelve young men between the ages of 15 and 24 who had recently attempted to take their own life. The analysis is based on a grounded theory approach. The young men who participated in this study had a broadly similar background, insofar as they all came from broken families and had dropped out from school at an early age. They also all faced similar problems, such as unemployment and alcohol abuse. On this basis a model describing the pathways leading to the suicide attempts was constructed based on the informants’ experiences. In all cases the decision to attempt suicide was found to be an expression of frustration with the present conditions of life. Combined with this was the traumatic influence of a troubled childhood within an unloving, unstable family. Attention has been paid to the ambivalent and antagonistic relationships that the informants experienced within their own families from childhood onwards, and the subsequent inability to establish any meaningful relationships in later life. This study aims to increase our understanding of the complexity of suicidal behaviours in order to help develop genderspecific prevention strategies.

  • 31. Persson, Margareta
    et al.
    Winkvist, Anna
    Dahlgren, Lars
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Mogren, Ingrid
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    "Struggling with daily life and enduring pain": a qualitative study of the experiences of pregnant women living with pelvic girdle pain2013In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 13, p. 111-Article in journal (Refereed)
    Abstract [en]

    Background: Few studies have investigated the experiences of living with pelvic girdle pain (PGP) and its impact on pregnant women's lives. To address this gap in knowledge, this study investigates the experiences of women living with PGP during pregnancy. Methods: A purposive sample, of nine pregnant women with diagnosed PGP, were interviewed about their experiences. Interviews were recorded, transcribed to text and analysed using a Grounded Theory approach. Results: The core category that evolved from the analysis of experiences of living with PGP in pregnancy was "struggling with daily life and enduring pain". Three properties addressing the actions caused by PGP were identified: i) grasping the incomprehensible; ii) balancing support and dependence and iii) managing the losses. These experiences expressed by the informants constitute a basis for the consequences of PGP: iv) enduring pain; v) being a burden; vi) calculating the risks and the experiences of the informants as vii) abdicating as a mother. Finally, the informants' experiences of the consequences regarding the current pregnancy and any potential future pregnancies is presented in viii) paying the price and reconsidering the future. A conceptual model of the actions and consequences experienced by the pregnant informants living with PGP is presented. Conclusions: PGP during pregnancy greatly affects the informant's experiences of her pregnancy, her roles in relationships, and her social context. For informants with young children, PGP negatively affects the role of being a mother, a situation that further strains the experience. As the constant pain disturbs most aspects of the lives of the informants, improvements in the treatment of PGP is of importance as to increase the quality of life. This pregnancy-related condition is prevalent and must be considered a major public health concern during pregnancy.

  • 32.
    Öhman, Ann
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Hägg, Kerstin
    Umeå University, Faculty of Social Sciences, Department of Child and Youth education, Special Education and Counselling (BUSV).
    Dahlgren, Lars
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    A stimulating, practice-based job facing increased stress: Clinical supervisors’ perceptions of professional role, physiotherapy education and the status of the profession2005In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 7, no 3, p. 114-122Article in journal (Refereed)
    Abstract [en]

    The aim was to study perceptions of professional role, education and the status of the profession among clinical physiotherapy supervisors. Five focus group discussions were conducted with 15 supervisors attached to four universities in Sweden. Qualitative analyses were carried out using constant comparisons. Triangulation of researchers was used to increase trustworthiness. The supervisors experienced themselves as being in the centre of two competing and changing fields - the academic setting and the clinic in healthcare organization. The contact with students and their updated knowledge base were the most positive aspects of being clinical supervisors. To create a good learning environment for the students was considered important, but lack of time in all aspects of the work created stress and dissatisfaction. Students’ hands-on skills and treatment techniques were regarded to be rather poor and there is too much emphasis on theoretical knowledge and research methods in the curriculum. The physiotherapy profession has potentials to develop in innovative fields such as health promotion and disease prevention outside the hospitals, but healthcare with its hierarchical organization is a hindrance for this development. Collaborative efforts to bridge the gap between university and clinical setting are needed.

  • 33.
    Öhman, Ann
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hägg, Kerstin
    Umeå University, Faculty of Social Sciences, Department of Child and Youth education, Special Education and Counselling (BUSV).
    Dahlgren, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Competent women and competing professions: Physiotherapy educators' perceptions of the field1999In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 1, no 2, p. 59-72Article in journal (Refereed)
    Abstract [en]

    Career choices are still strongly gendered in health care professions. In Sweden, physiotherapy is a middle-class women's profession that nowadays also attracts men. Career strategies and professional development in physiotherapy are sparsely studied from a gender perspective. The purpose of this qualitative study was to describe and analyse perceptions of individual professional development, physiotherapy education and the profession in general, among a group of women educators in physiotherapy, using a gender theoretical framework and some of Bourdieu's theoretical concepts in the analysis. Thematized in-depth interviews with fourteen educators in physiotherapy were performed. The analysis used the Grounded Theory method of constant comparison. To increase credibility, the study design used triangulation in interviewers and investigators, member checking and reference group checking. Three core categories were identified. The Competent Woman category involves the professional development of the educators, including aspects of competence, success, efficiency and flexibility. Perceptions of femininity and masculinity reflect the symbolic dimension of gender. Femininity is regarded as symbolic capital for empathy and care, while masculinity represents status and power. The core category Theory-Practice Gap describes the isolated position of physiotherapy education in relation to the field of health care. The fragmented and disintegrated professional knowledge base does not facilitate the development of the profession. The core category Profession under Change reflects ideas about physiotherapy in society. Other female health care professions, ongoing societal change and conservative physiotherapy practices constitute a threat to the future development of the field. Visions for future development of the field emphasized the importance of professional competence and engagement in innovative activities in new arenas and new professional roles. The results shed light on the symbolic dimension of gender in a professional field where femininity is connected with academic success, empathy and care, while masculinity is related to business mentality, status and power. Notions of competition include both internal and external factors affecting the field of physiotherapy.

  • 34.
    Öhman, Ann
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Dahlgren, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Career choice, professional preferences and gender ?:  the case of Swedish physiotherapy students2001In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 3, no 3, p. 94-107Article in journal (Refereed)
    Abstract [en]

    The aim was to identify reasons for the career choice and professional preferences among students enrolled in the Swedish physiotherapy education. The study design was longitudinal and used a questionnaire administered to a cohort of 273 students in the beginning of the university programme in 1997 as well as at the completion of the programme in 1999, yielding a response rate of 93%. Data were analysed with factor analysis and univariate and multivariate logistic regression analysis. To test the relationship between the factors and outcomes that showed significant effect in the logistic regression analysis, a path analysis was performed. The two most preferred healthcare facilities after graduation were sports medicine clinics and fitness centres. Future work in private practice was highly endorsed by a majority of students. Health promotion was highly valued. Care of elderly and hospital work were not preferred. Significant differences between men and women appeared. Men were more likely to have chosen the programme because of their interest in sports and physical activity. Men were also more choice decided about future professional activities, whereas women were more open for several areas of practice. Men preferred to become the owner of a private clinic and to work with alternative approaches to healthcare, such as fitness training in sports medicine clinics.

1 - 34 of 34
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