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Introduction: Severe perineal trauma (SPT), defined as third- or fourth-degree lacerations during childbirth, is a known risk factor for adverse postpartum health-related quality of life (HRQoL). Although HRQoL may improve within six months postpartum, up to 30% of affected women in Sweden report long-term health problems beyond one year. While qualitative studies highlight the broad negative impact, quantitative findings remain inconclusive, particularly regarding the role of pelvic floor symptoms and the degree of SPT, underscoring the need for further research. The aim is to assess and compare HRQoL in a sample of women with SPT, and to identify predictors of physical and mental health at least 18 months postpartum.

Methods: A nationwide cross-sectional study was conducted in Sweden using an online questionnaire to assess HRQoL via the validated RAND-36 instrument. Linear regression analysis was employed to explore associations.

Results: Two hundred and twenty-one women with SPT and varying symptom bother from SPT, at least 18 months after the childbirth, responded. The study population exhibited worse-than-average RAND-36 scores across most dimensions (apart from physical functioning and pain) compared to normative data for women in Sweden. Further, the mean physical health score was significantly lower in our study sample (M = 70.7, SD = 22.1) compared to the reference population of women in Sweden (M = 73.63, SD = 29.45), t [df (degrees of freedom) 220] = −1.99, p = 0.047, Cohen's d = 0.13. The mean mental health score was significantly lower in our study sample (M = 63.2, SD = 21.4) compared to normative Swedish women (M = 71.7, SD = 27.15), t (df 220) = −5.90, p < 0.001, Cohen's d = 0.40. Health change over the past year remained relatively static with a slight trend towards improvement (mean 54.5; SD 21.6; CI 95% 51.6–57.4). Physical health was predicted by the extent of symptom bother, perceived work ability, educational attainment, and level of physical activity. Mental health was predicted by age, extent of symptom bother, and perceived work ability.

Conclusions: These findings underscore the need for individualized, multidisciplinary care strategies that address both physical and psychological dimensions of recovery after sustaining SPT at childbirth. Future research should investigate the barriers and facilitators influencing HRQoL, to enhance HRQoL and support the reintegration of women with SPT into their social and professional spheres. A deeper understanding of the socioeconomic and occupational contexts of affected women is essential to promote more equitable health outcomes.

Objective: Existing literature offers fragmented insights into working life following severe perineal trauma (SPT), suggesting positive and negative implications. No research has systematically examined work ability or potential risk factors associated with impaired work ability. This study assessed and compared work ability among women with SPT more than 18 months postpartum and identified potential risk factors for impaired work ability.

Methods: An exploratory cross-sectional pilot study was conducted in Sweden. Participants were recruited via digital platforms (n = 197) and included women who sustained SPT during childbirth more than 18 months before data collection. Data were collected via an online questionnaire and analysed using multivariable logistic regression.

Results: Nearly one-third of participants reported impaired work ability. Absence of reconstructive surgery, increased life impact of pelvic floor disorders, and history of sick leave in adult life were identified as risk factors for impaired work ability.

Conclusions: The complexity of health problems following SPT may affect women’s ability to work. Given the exploratory nature and limited sample size of this pilot study, larger longitudinal studies – using national registers or multicentre recruitment – are needed to confirm the observed associations and deepen understanding of the multifaceted consequences of health problems following SPT.

I antologin presenteras feministiska teorier och begrepp tillsammans med exempel på tillämpning i forskning. Kapitlet handlar om kropp och hälsa i relation till genusteorier och empiriska exempel från forskning. 

Background: Physical activity and exercise are promoted worldwide as effective interventions for healthy ageing. Various exercise initiatives have been developed and evaluated for their efficacy and effectiveness among older populations. However, a deeper understanding of participants’ experiences with these initiatives is crucial to foster long-term activity and exercise among older persons.

Methods: A constructivist grounded theory study was conducted to explore the experiences of older persons participating in a supervised group supramaximal high-intensity training (HIT) programme. Four focus groups were held, involving 28 persons aged 65 to 78. The focus groups were analysed inductively, followed by an iterative process of abstraction, abduction, and theory generation using a constant comparative method. A conceptual framework comprising three theoretical concepts—stereotype embodiment, ageist practices, and self-efficacy—was employed during the abductive phase as an analytical lens.

Results: The core category of our grounded theory, Negotiating a physically active life in tune with ageing, encapsulates the complex processes and actions influencing older persons as they engage in physical activities in their daily lives and in relation to HIT. This core category was created from the conceptual framework and the four categories: Grit in the moment and overall life, Empowered by the training group, Navigating one’s physically active self, and Committing to exercise for duty and pleasure. Participants reported feeling invigorated by the exercise, enjoying the challenge, and valuing the group setup for its social connectedness and structure. The generated theory illustrates how participants’ engagement with physical activity and exercise is shaped by various perspectives accumulated over their lifespan. The findings provide a plausible explanation of how participation in HIT groups can challenge negative age stereotypes and ageist practices while enhancing self-efficacy for high-intensity exercise.

Conclusions: Our grounded theory underscores that physical activity and exercise should be regarded as multifaceted processes, which must be considered when promoting physical activity initiatives for older persons. By considering the older person and societal norms and values, we can gather knowledge to design physical exercise interventions that are not only effective but also enjoyable and capable of transforming how individuals perceive themselves as exercising persons.

This study aimed to explore school nurses’ experience of using physical activity on prescription with children in Swedish compulsory school. Semistructured interviews were conducted with 24 school nurses who had the educational qualification to prescribe physical activity. The analysis resulted in one overarching theme, “A delicate process of tailoring physical activity on prescription to a child's social context,” and two categories: “Promoting joyful physical activity through individualization and support” and “Dealing with dilemmas and challenges,” with related subcategories. The results demonstrate the importance of tailoring prescribed physical activity to each individual child, their living conditions, and the school context. In addition, they highlight the nurses’ working conditions and collaborations as important prerequisites when initiating physical activity on prescription. In conclusion, the results suggest that school nurses perceive physical activity on prescription as a useful tool in the school context, but it needs to be tailored to each individual child.

Background: Supramaximal high-intensity interval training (HIT) programmes can be challenging to replicate outside research settings. This study aimed to explore its feasibility for older adults in a community setting, incorporating perspectives from exercise participants and instructors.

Methods: A pragmatic feasibility study using a convergent mixed- methods design involving four exercise instructors from one training facility and 21 older adult exercise participants (14 women, age-range 65–78). The previously used HIT programme consisted of 20-minute sessions that included a warm-up, ten 6-second intervals, and cool-down. Instructors first adapted the programme around these core components to their setting and then conducted 25 sessions. Both qualitative (individual interviews) and quantitative (estimated maximal oxygen consumption, estimated 6-second power, exercise- related motivation, and self-efficacy) data were collected and analysed (content analysis and descriptive statistics) in parallel. A taxonomy for implementation outcomes was used as an analytical matrix.

Results: Experiences of both participants and instructors revealed that the structure of the training was regarded as engaging, enjoyable, and supportive for establishing routines and promoting ownership of training progression. Participants found personalised and motivating approaches to engage with the programme and confidence in their abilities grew. Changes in exercise-related motivation and self-efficacy showed individual variation without a group trend. Participants who completed the intervention showed a positive median change in estimated 6-second power and maximal oxygen consumption, although individual responses varied. Experienced challenges included coordinating tasks during intervals and confidence in managing the programme. Barriers to fidelity and to scale-up were related to the practical complexity and fixed structure.

Conclusions: Supramaximal HIT can be implemented for older adults in a community setting with appropriate support, including individualised watt-based intensity and structured progression. The findings highlight how participants took ownership of their intensity progression, enabling them to challenge their limits. However, the fixed structure and complexity in managing short intervals may pose barriers to broader adoption. To enhance feasibility and scalability, simplifying interval management and providing clear, structured guidance are recommended. These insights help refine and optimize supramaximal HIT implementation for older adults in community settings.

Trial registration: Open Science Framework 31 January 2023 (https://doi.org/10.17605/OSF.IO/B7T2G).

School nurses are in a key position to promote children's physical activity. They engage all children in health dialogues and use different approaches to inform children about physical activity and motivate them to change their physical activity level. In a school context, it is important to explore and problematize school nurses' views of children's physical activity and the influence of these views on their professional practice in the school health service. Identifying and problematizing school nurses' views of physical activity would enable them to create improved guidelines and equivalent ways of working in the future. Therefore, this study aims to discursively explore Swedish school nurses' views on school children's physical activity and its promotion and elucidate them through a discursive framework based on sensitizing concepts. This study uses a qualitative research design with a constructivist grounded theory approach. Semi-structured interviews were conducted with 24 school nurses. The analysis resulted in a core category describing how school nurses use intertwined views to lead children from sedentarity to physical activity. Furthermore, the school nurses' practices were identified in three categories: fostering everyday movement as a tool for health, battling children's sedentarity under difficult conditions, and promoting everyday movement and compensating for unequal access. The results indicate that school nurses lack common and clear guidelines for their mission to promote physical activity to children, which may lead to inequality in access to physical activity for children and young people.

Background: Youth mental health is a major health concern in almost every country. Mental health accounts for about 13% of the global burden of disease in the 10-to-19-year age group. Still there are significant gaps between the mental health needs of young people and the quality and accessibility of available services. Collaboration between health and social service actors is a recognized way of reducing gaps in quality and access. Yet there is little scientific evidence on how these collaborations are applied, or on the challenges of cross-boundary collaboration in the youth mental health space. This study aims to explore how collaboration is understood and practiced by professionals working in the Swedish youth mental health system.

Methods: We conducted 42 interviews (November 2020 to March 2022) with health and social care professionalsand managers in the youth mental health system in Sweden. Interviews explored participants’ experience andunderstanding of the purpose, realization, and challenges of collaboration. Data were analysed under an emergentstudy design using reflexive thematic analysis.

Results: The analysis produced three themes. The first shows that collaboration is considered as essential andimportant, and that it serves diverse purposes and holds multiple meanings in relation to professionals’ roles andresponsibilities. The second addresses the different layers of collaboration, in relation to activities, relationships, andtarget levels, and the third captures the challenges and criticisms in collaborating across the youth mental healthlandscape, but also in growing possibilities for future development.

Conclusion: We conclude that collaboration serves multiple purposes and takes many shapes in the Swedish youth mental health system. Despite the many challenges, participants saw potential in further building collaboration. Interestingly our participants also raised concerns about too much collaboration. There was scepticism about collaboration directing attention away from young people to the professionals, thereby risking the trust and confidentiality of their young clients. Collaboration is not a panacea and will not compensate for an under-resourced youth mental health system.

In Swedish school health services, local initiatives have been taken to use physical activity on prescription (PAP) to encourage physically inactive children to become more active. Previous research shows that interprofessional collaboration plays a crucial role in promoting physical activity in children, as well as in promoting health in schools. However, there is a lack of knowledge about PAP for children in the school setting, including how medical and educational staff can work together to encourage children who have been recommended PAP. Therefore, this study aims to explore the perceived facilitators and barriers concerning interprofessional collaboration regarding physical activity on prescription in the school setting, as viewed from the professionals’ perspectives. Semi-structured interviews were conducted with 21 professionals who work with the method in school settings. The data were analyzed using Reflexive Thematic Analysis. The results reveal both barriers and facilitators for interprofessional collaboration on PAP in the school setting, as perceived by professionals. Organizational and structural obstacles within school institutions hinder collaboration, while a shared commitment to PAP, characterized by consensus-building, acts as a facilitating factor. PAP for children in a school setting is still an unexplored area and further research is required.

BACKGROUND: During the first year postpartum, about 25 per cent of Swedish women with severe perineal trauma (SPT), i.e., a third- or fourth-degree perineal laceration at childbirth, are unsatisfied with their healthcare contacts. Further, there is a lack of research on the more long-term experiences of healthcare encounters among women with persistent SPT-related health problems. This study explores how women with self-reported persistent SPT-related health problems experience their contact with healthcare services 18 months to five years after childbirth when the SPT occurred.

METHODS: In this descriptive qualitative study, a purposive sample of twelve women with self-reported persistent health problems after SPT were individually interviewed from November 2020 - February 2022. The data was analysed using inductive qualitative content analysis.

RESULTS: Our results showed a paradoxical situation for women with persistent health problems due to SPT. They struggled with their traumatised body, but healthcare professionals rejected their health problems as postpartum normalities. This paradox highlighted the women's difficulties in accessing postpartum healthcare, rehabilitation, and sick leave, which left them with neglected healthcare needs, diminished emotional well-being, and loss of financial and social status. Our results indicated that these health problems did not diminish over time. Consequently, the women had to search relentlessly for a 'key person' in healthcare who acknowledged their persistent problems as legitimate to access needed care, rehabilitation, and sick leave, thus feeling empowered.

CONCLUSIONS: Our study revealed that women with persistent SPT-related health problems experienced complex health challenges. Additionally, their needs for medical care, rehabilitation, and sick leave were largely neglected. Thus, the study highlights an inequitable provision of SPT-related healthcare services in Sweden, including regional disparities in access to care. Hence, the authors suggest that Swedish national guidelines for SPT-related care need to be developed and implemented, applying a woman-centered approach, to ensure equitable, effective, and accessible healthcare.