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Aléx, Lena
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Publications (10 of 45) Show all publications
Eivergård, K., Enmarker, I., Livholts, M., Aléx, L. & Hellzén, O. (2021). Disciplined into good conduct: Gender constructions of users in a municipal psychiatric context in Sweden. Journal of Clinical Nursing, 30(15-16), 2258-2269
Open this publication in new window or tab >>Disciplined into good conduct: Gender constructions of users in a municipal psychiatric context in Sweden
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2021 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 30, no 15-16, p. 2258-2269Article in journal (Refereed) Published
Abstract [en]

Aims and objectives: To examine how gendered discursive norms and notions of masculinity and femininity were (re)produced in professional conversations about users of long-term municipality psychiatric care. Focus is on the staff's use of language in relation to gender constructions.

Background: Psychiatric care in Sweden has undergone tremendous changes in recent decades from custodian care in large hospitals to a care mainly located in a municipal context. People who need psychiatric care services often live in supporting houses. In municipal psychiatric care, staff conduct weekly professional meetings to discuss daily matters and the users' needs. Official reports of the Swedish government have shown that staff in municipal care services treat disabled women and men differently. Studies exploring gender in relation to users of long-term psychiatric care in municipalities have problematised the care and how staff, through language, construct users' gender. Therefore, language used by staff is a central tool for ascribing different gender identities of users.

Design: The content of speech derived from audio recordings was analysed using Foucauldian discourse analysis. The COREQ checklist was used in this article.

Results: The results indicate that by relying on gender discourses, staff create a conditional care related to how the users should demonstrate good conduct. In line with that, an overall discourse was created: Disciplined into good conduct. It was underpinned by three discourses inherent therein: The unreliable drinker and the confession, Threatened dignity, and Doing different femininities.

Conclusion: The community psychiatric context generates a discourse of conduct in which staff via spoken language (re)produces gendered patterns and power imbalances as a means to manage daily work routines. Such practices of care, in which constant, nearly panoptic, control despite the intention to promote autonomy, urgently require problematising current definitions of good conduct and normality.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
disability, discourse analysis, femininity, Foucault, masculinity, mental illness
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-183578 (URN)10.1111/jocn.15666 (DOI)000647320500001 ()33460478 (PubMedID)2-s2.0-85105168795 (Scopus ID)
Available from: 2021-06-02 Created: 2021-06-02 Last updated: 2022-11-28Bibliographically approved
Eivergård, K., Enmarker, I., Livholts, M., Aléx, L. & Hellzén, O. (2020). Subordinated masculinities: a critical inquiry into reproduction of gender norms in handovers and rounds in a forensic psychiatric care. Journal of Clinical Nursing, 29(21-22), 4227-4238
Open this publication in new window or tab >>Subordinated masculinities: a critical inquiry into reproduction of gender norms in handovers and rounds in a forensic psychiatric care
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2020 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 29, no 21-22, p. 4227-4238Article in journal (Refereed) Published
Abstract [en]

Aims and objectives: To examine how gendered discursive norms and notions of masculinity are (re)produced in professional conversations about men cared for as patients in forensic psychiatric care, with a particular focus on the centrality of language and gender.

Background: During verbal handovers and ward rounds, care staff converse to share information about patients and make decisions about their mental status. Spoken language is thus a pivotal tool in verbal handovers and ward rounds, one able to reproduce discourses and gender norms.

Design: Qualitative. Data collected from audio recordings of verbal handovers and ward rounds in a forensic psychiatric clinic were subjected to discourse analysis. The COREQ checklist was used.

Results: While discussing patients, staff subordinated them by reproducing a discourse typical of heteronormative, family‐oriented care. The overarching discourse, which we labelled subordinated masculinities, was supported by three other discourses: being unable to take responsibility, being drug‐addicted and performing masculinity. Such discourse was identified as a disciplining practice that subordinate's patients as a means to maintain order, rules and gender norms.

Conclusion: The study reveals a caring practice that position male patients as children or disabled individuals and, in that way, as subordinated other men within a context were staff reproduces a heteronormative family structured care. The process also reveals a practice were downplaying aggressive and deviant behaviour could disempower and reduce patients' responsibility for personal actions and their possibilities to participate in their care. That finding especially seems to contradict previous findings that patients want to be able to act responsibly and, to that end, want care staff to help them.

Relevance to clinical practice: Nurses need to deepen their understanding of how language (re)produces discursive norms of gender and masculinity in forensic care and that process's consequences for such care.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
discourse, forensic care, masculinity, power, verbal handovers
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-174872 (URN)10.1111/jocn.15456 (DOI)000563406200001 ()32786169 (PubMedID)2-s2.0-85089917120 (Scopus ID)
Available from: 2020-09-17 Created: 2020-09-17 Last updated: 2021-01-13Bibliographically approved
Eivergård, K., Enmarker, I., Livholts, M., Aléx, L. & Hellzén, O. (2019). The Importance of Being Acceptable: psychiatric Staffs' Talk about Women Patients in Forensic Care. Issues in Mental Health Nursing, 40(2), 124-132
Open this publication in new window or tab >>The Importance of Being Acceptable: psychiatric Staffs' Talk about Women Patients in Forensic Care
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2019 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 40, no 2, p. 124-132Article in journal (Refereed) Published
Abstract [en]

Currently, women comprise about ten percent of those sentenced to psychiatric forensic clinics in Sweden. Those who are sentenced to forensic care because of offending and violent behaviour have already taken a step away from the usually expected female behaviour. On the other hand, there are many women in forensic care who have not committed crimes, but who instead self-harm. Studies have identified a gender bias in diagnosing and care in psychiatric settings, but there are few studies conducted on women in forensic care. The present study therefore examined how the situation of women patients and female norms are expressed in the staff's talk about these women during verbal handovers and ward rounds at a forensic clinic in Sweden. The aim was to explore how psychiatric staff, in a context of verbal handovers and ward rounds, talk about women who have been committed to forensic psychiatric care, and what consequences this might have for the care of the patients. The content of speech was examined using audio recordings and a method of analysis that was inspired by thematic analysis. The analysis identified that the staff talked about the women in a way that indicates that they expected the women to follow the rules and take responsibility for their bodies in order to be regarded as acceptable patients.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2019
National Category
Nursing Psychiatry
Identifiers
urn:nbn:se:umu:diva-158760 (URN)10.1080/01612840.2018.1514551 (DOI)000463571900006 ()30481089 (PubMedID)2-s2.0-85057627205 (Scopus ID)
Available from: 2019-05-13 Created: 2019-05-13 Last updated: 2023-03-24Bibliographically approved
Kautto, E., Olsson, C., Ivarsson, A., Lyon, P., Hörnell, A. & Alex, L. (2017). Living with celiac disease: norms of femininity and the complications of everyday life. International Journal of Celiac Disease, 5(3), 115-124
Open this publication in new window or tab >>Living with celiac disease: norms of femininity and the complications of everyday life
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2017 (English)In: International Journal of Celiac Disease, ISSN 2334-3427, Vol. 5, no 3, p. 115-124Article in journal (Refereed) Published
Abstract [en]

Women with celiac disease are often described as being exposed to negative emotions and experiences related to the treatment of celiac disease, the gluten-free diet. To explore the daily consequences of diagnosis and their daily experiences of living with celiac disease, interviews were conducted with seven Swedish young women who had been diagnosed with celiac disease by screening in early adolescence. The semi-structured interview transcripts were content analysed using a gender perspective. The analysis showed that these young women`s daily experiences were coloured by the conjunction of their dietary treatment, their social relationships, and social norms. This means that recurrent food situations often clash with the normative constructions of femininity and social norms of eating with an adverse effect on dietary compliance.

Place, publisher, year, edition, pages
Science and Education Publishing, 2017
Keywords
adherence/compliance, gluten-free diet, gender, young adults
National Category
Gastroenterology and Hepatology Gender Studies
Identifiers
urn:nbn:se:umu:diva-138488 (URN)10.12691/ijcd-5-3-4 (DOI)2-s2.0-85027192348 (Scopus ID)
Available from: 2017-08-24 Created: 2017-08-24 Last updated: 2025-02-25Bibliographically approved
Nygren, B., Aléx, L., Jonsén, E., Gustafson, Y., Norberg, A. & Lundman, B. (2017). Resilience, sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health among the oldest old. In: Martin Orrell; Aimee Spector (Ed.), Psychology of aging: (pp. 85-93). Routledge
Open this publication in new window or tab >>Resilience, sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health among the oldest old
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2017 (English)In: Psychology of aging / [ed] Martin Orrell; Aimee Spector, Routledge, 2017, p. 85-93Chapter in book (Refereed)
Abstract [en]

Different concepts have been presented which denote driving forces and strengths that contribute to a person’s ability to meet and handle adversities, and keep or regain health. The aim of this study, which is a part of The Umea 85+ study, was to describe resilience, sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health in a sample of the oldest old. The study sample consisted of 125 participants 85 years of age or older, who ranked themselves on the Resilience Scale, Sense of Coherence Scale, Purpose in life Scale and Self-Transcendence Scale and answered the SF-36 Health Survey questionnaire. The findings showed significant correlations between scores on the Resilience Scale, the Sense of Coherence Scale, the Purpose in Life Test, and the Self-Transcendence Scale. Significant correlations were also found between these scales and the SF-36 Mental Health Summary among women but not among men. There was no significant correlation between perceived physical and mental health. The mean values of the different scales showed that the oldest old have the same or higher scores than younger age groups. Regression analyses also revealed sex differences regarding mental health. The conclusions are that, the correlation between scores on the different scales suggests that the scales measure some dimension of inner strength and that the oldest old have this strength at least in the same extent as younger adults. Another conclusion is that the dimensions that constitute mental health differ between women and men.

Place, publisher, year, edition, pages
Routledge, 2017
Series
The International Library of Psychology
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-203581 (URN)2-s2.0-85145829623 (Scopus ID)9781351907859 (ISBN)9780754627890 (ISBN)
Note

Published in printed form 2009.

Available from: 2023-01-19 Created: 2023-01-19 Last updated: 2025-02-25Bibliographically approved
Harryson, L., Aléx, L. & Hammarström, A. (2016). "I have surly passed a limit, it is simply too much": women's and men's experiences of stress and wellbeing when living within a process of housework resignation. BMC Public Health, 16, Article ID 224.
Open this publication in new window or tab >>"I have surly passed a limit, it is simply too much": women's and men's experiences of stress and wellbeing when living within a process of housework resignation
2016 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 16, article id 224Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Gender inequality within paid and unpaid work exposes women and men to different environments and responsibilities. These gender patterns shape living conditions for women and men, either negatively or positively, by affecting the prospect of good health. Most public health studies of gender and housework are quantitative, and knowledge about the relationship between housework experiences and health for women and men is limited. The aim of this study was to explore the housework experiences and practices of women and men and their experiences of stress and perceived wellbeing from a gender perspective.

METHODS: We conducted thematic interviews with four women and four men living in Sweden, and performed an analysis using the Grounded Theory method.

FINDINGS: We found that stereotypical gender practices in housework influenced experiences of stress and perceived wellbeing among women and men. Despite proposing gender equality in housework as a means of improving wellbeing, inequality was amplified by the way women and men handle the gendered division of housework. We call this recurring theme "The process of housework resignation", which also constitute the core category in our analysis. "The process of housework resignation" was theorised from the categories "Gender practices in housework", "Experiencing stress and wellbeing" and "Managing daily life".

CONCLUSIONS: Stereotypical gender practices in housework can increase experiences of stress among women and men. Challenging stereotypical masculinities can be a key for breaking the process of resignation in housework and for facilitating improved health among both women and men in heterosexual couple relationships within a Swedish context.

Place, publisher, year, edition, pages
BioMed Central, 2016
Keywords
Housework, Gender equality, Health, Wellbeing, Stress, Grounded theory, Masculinities, Femininities
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-118710 (URN)10.1186/s12889-016-2920-5 (DOI)000371866800001 ()26944701 (PubMedID)2-s2.0-84962692137 (Scopus ID)
Available from: 2016-03-30 Created: 2016-03-30 Last updated: 2023-08-28Bibliographically approved
Alex, L. (2016). Resilience among old Sami women. Ageing & Society, 36, 1738-1756
Open this publication in new window or tab >>Resilience among old Sami women
2016 (English)In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 36, p. 1738-1756Article in journal (Refereed) Published
Abstract [en]

There is lack of research on old indigenous women’s experiences. The aim of thisstudy was to explore how old women narrate their experiences of wellbeing andlack of wellbeing using the salutogenetic concept of resilience. Interviews fromnine old Sami women were analysed according to grounded theory with the followingthemes identified: contributing to resilience and wellbeing built up from the categoriesfeeling connected, feeling independent and creating meaning; andcontributing to lack of lack of resilience and wellbeing built up from the categoryexperiencing lack of connectedness. The old Sami women’s narratives showedthat they were to a high extent resilient and experienced wellbeing. They felt bothconnected and independent and they were able to create meaning of being anold Sami woman. Having access to economic and cultural capital were for the oldSami women valuable for experiencing resilience. Lack of resilience was expressedas experiences of discrimination, lack of connectedness and living on the borderof the dominant society. Analysis of the Sami women’s narratives can give wider perspectiveson women’s health and deepen the perspectives on human resilience andincrease the understanding of minority groups in a multicultural world.

Place, publisher, year, edition, pages
Cambridge University Press, 2016
Keywords
Sami women, resilience, gender, grounded theory, narratives
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-108073 (URN)10.1017/S0144686X15000719 (DOI)000382506300009 ()2-s2.0-84937605856 (Scopus ID)
Available from: 2015-09-03 Created: 2015-09-03 Last updated: 2023-03-23Bibliographically approved
Kautto, E., Olsson, C., Ivarsson, A., Lyon, P., Hörnell, A. & Alex, L. (2016). Seeking a new normality: masculinity, interaction and a gluten free diet. International Journal of Celiac Disease, 4(4), 138-145
Open this publication in new window or tab >>Seeking a new normality: masculinity, interaction and a gluten free diet
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2016 (English)In: International Journal of Celiac Disease, ISSN 2334-3486, Vol. 4, no 4, p. 138-145Article in journal (Refereed) Published
Abstract [en]

From earlier studies, men diagnosed with celiac disease are known to be less troubled by their experiences of living with the disease than are diagnosed women. Previous studies, concentrating on men with celiac disease have been mostly quantitative, and have a bio-medical emphasis. The aim of this study was to explore the social experience of young men with screening-detected celiac disease and to highlight daily life situations five years after diagnosis. Seven young men, diagnosed with celiac disease when they were 13 years-olds through a large Swedish school-based celiac screening-study, were interviewed. The semi-structured interviews were analyzed from a gender perspective which resulted in three themes; being subjected to changes, striving for normality and emphasizing commitment. These were underpinned by several sub-themes. The young men dissociated themselves from being seen as a person with a life-long chronic disease. The analysis also showed that the young men’s daily experiences of living with celiac disease largely depended on their use of characteristics known to be associated with masculinity: such as being self-assured, demanding, and behaving authoritatively. In food situations, where the young men had the ability to make use of such characteristics in their informal group, they experienced fewer negative aspects of the disease. If the young men did not hold a strong position in their informal group, their situation was insecure and vulnerable and this could lead to avoidance of contacts and social meal situations.

Keywords
celiac disease, young males, gender, masculinity, social norms
National Category
Public Health, Global Health and Social Medicine Gender Studies Other Social Sciences not elsewhere specified
Research subject
Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-129442 (URN)10.12691/ijcd-4-4-7 (DOI)2-s2.0-85010382769 (Scopus ID)
Available from: 2016-12-28 Created: 2016-12-28 Last updated: 2025-02-21Bibliographically approved
Hammarström, A., Johansson, K., Annandale, E., Ahlgren, C., Aléx, L., Christianson, M., . . . Verdonk, P. (2014). Central gender theoretical concepts in health research: the state of the art. Journal of Epidemiology and Community Health, 68(2), 185-190
Open this publication in new window or tab >>Central gender theoretical concepts in health research: the state of the art
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2014 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 68, no 2, p. 185-190Article in journal (Refereed) Published
Abstract [en]

Despite increasing awareness of the importance of gender perspectives in health science, there is conceptual confusion regarding the meaning and the use of central gender theoretical concepts. We argue that it is essential to clarify how central concepts are used within gender theory and how to apply them to health research. We identify six gender theoretical concepts as central and interlinked-but problematic and ambiguous in health science: sex, gender, intersectionality, embodiment, gender equity and gender equality. Our recommendations are that: the concepts sex and gender can benefit from a gender relational theoretical approach (ie, a focus on social processes and structures) but with additional attention to the interrelations between sex and gender; intersectionality should go beyond additive analyses to study complex intersections between the major factors which potentially influence health and ensure that gendered power relations and social context are included; we need to be aware of the various meanings given to embodiment, which achieve an integration of gender and health and attend to different levels of analyses to varying degrees; and appreciate that gender equality concerns absence of discrimination between women and men while gender equity focuses on women's and men's health needs, whether similar or different. We conclude that there is a constant need to justify and clarify our use of these concepts in order to advance gender theoretical development. Our analysis is an invitation for dialogue but also a call to make more effective use of the knowledge base which has already developed among gender theorists in health sciences in the manner proposed in this paper.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2014
Keywords
Gender, public health, social inequalities
National Category
Public Health, Global Health and Social Medicine Nursing
Identifiers
urn:nbn:se:umu:diva-84828 (URN)10.1136/jech-2013-202572 (DOI)000329487900007 ()24265394 (PubMedID)2-s2.0-84894093993 (Scopus ID)
Funder
Swedish Research Council, 344-2006-7280, 344-2011-5478
Available from: 2014-01-20 Created: 2014-01-20 Last updated: 2025-02-20Bibliographically approved
Johansson, E., Aléx, L. & Christianson, M. (2014). Gendered discourses of youth sexualities - an exploration of PubMed articles on prevention of sexually transmissible infections. Sexual & Reproductive HealthCare, 5(3), 81-89
Open this publication in new window or tab >>Gendered discourses of youth sexualities - an exploration of PubMed articles on prevention of sexually transmissible infections
2014 (English)In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 5, no 3, p. 81-89Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To explore how gender is addressed in medical articles on the prevention of sexually transmissible infections (STI) among adolescents.

METHODS: Sixtyone articles were retrieved from a PubMed search and scrutinized by qualitative content analysis.

RESULTS: Most articles were affiliated with North American research institutions, but there were also reports from Europe, Africa, South America, and Asia. Gender turned up in the following four recurrent discourses: Gendered Receptiveness for Information, Stereotyped Heterosexual Expectations, Power Imbalance in Sexual Relations, and Gendered Prevention Approaches. Young women were described as knowledgeable, communicative, and responsible, but at risk because of feminine ideals and a lack of negotiating power. Men were described as less informed, more reluctant to discuss, and more risk taking due to masculine ideals and power dominance. Prevention approaches concerned how to postpone sex and/or tailor gender-sensitive programs for specific groups of young women and men.

CONCLUSION: Researchers' own gender expectations might have a substantial impact on how sex and sexual health is considered in prevention research. To avoid reconstruction of current inequalities and stereotypes regarding sexual practices of young women and men, the impact of gender, the power structures in intimate relations, and the cultural context should be considered. Medical research on STI prevention could benefit from including a wider array of gender perspectives.

Keywords
sexually transmisible infection, prevention, sex, gender, qualitative analysis, youth
National Category
Health Sciences
Identifiers
urn:nbn:se:umu:diva-94747 (URN)10.1016/j.srhc.2014.07.002 (DOI)000342889200001 ()25200967 (PubMedID)2-s2.0-84908162112 (Scopus ID)
Available from: 2014-10-16 Created: 2014-10-16 Last updated: 2023-03-23Bibliographically approved
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