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Introduction: The experiences of living with Parkinson's disease (PD) from the perspective of newly diagnosed persons with PD (PwPD) have not been previously described. Aim: This study aimed to gain a better understanding of the impact of living with the early stages of PD. Methods: A qualitative interview study was conducted among nine persons, seven men and two women, from southern Sweden. Participants had a median age of 71 (min–max, 64–77) years and had been diagnosed with PD for a median of 5 (min–max, 2–12) months. Interviews were recorded and analysed using systematic text condensation. Results: The analysis resulted in one core category, Facing and dealing with emotional turbulence, and four categories with 2–3 subcategories each: Something is wrong (Vague signs of change; Losing control); The going gets tough (Recalling; Lack of motivation); Losing direction (Uncertainties; Frightened of disease progression) and Dealing with life (Avoiding social situations; Hope and despair; Ease worries). Conclusion: Newly diagnosed PwPD face emotional turbulence with increasing challenges in managing everyday basic needs. Impaired functioning affects self‐esteem and identity, which calls for strategies to overcome emotional reactions of embarrassment, frustration and worry. A sense of lost control and direction increased as the future became more uncertain. The participants' emotional burden and struggle to find a reason to go on or some solution to their new situation left them with both hope and despair. Our results suggest that a person‐centred needs‐based approach may help newly diagnosed PwPD deal with their new life situation. [ABSTRACT FROM AUTHOR]

Background: Childhood cancers affect about 350 children every year in Sweden and are life-threatening diseases. During the treatment period, situations arise that can become morally challenging for the child. When knowing children's values and morally challenging situations in childhood cancer care, targeted ethics support could be developed and used in care. Aim: To explore children's values and moral dilemmas ​​when undergoing cancer treatment. Methods: This is a qualitative study based on empirical data. The data collection was conducted through three focus group interviews and six individual interviews with children between 10 and 18 years (n = 16). A content analysis methodology was used to generate themes. Children who were/have been treated for cancer at three childhood cancer centres in Sweden were invited to participate. The study was approved by the Swedish Ethical Review Authority. The children's participation was based on voluntariness and consent/assent. Findings: During the analysis, five themes of values emerged: Personal relationships, Bodily ease and identity, Feeling in control and being involved, Positive distractions and Right care that is needed. Their moral dilemmas were thematized into: Should I consider others or not? Should I rest or not? and Should I refuse treatment or not? Conclusion: Children undergoing cancer treatment want to have personal relationships with healthcare professionals. Their moral dilemmas were about questioning their own physical and psychological well-being against their expectations, the values of others and the treatment required. Further research is needed to understand how to deal with moral dilemmas in children undergoing cancer treatment. [ABSTRACT FROM AUTHOR]

Background: The electronic medication administration record (eMAR) is an eHealth system that has replaced the traditional paper‐based medication administration used in many healthcare settings. Research has highlighted that eHealth technologies can change working methods and professional roles in both expected and unexpected ways. To date, there is sparse research that has explored how nurses and nurse assistants (NA) in home healthcare experience eMAR in relation to their work environment. Aim: The aim was to explore how nurses and nurse assistants experienced their work environment, in terms of job‐demand, control, and support in a Swedish home healthcare setting where an electronic medication administration record had been implemented to facilitate delegation of medical administration. Method: We took a qualitative approach, where focus groups were used as data collection method. The focus groups included 16 nurses and nine NAs employed in a Swedish municipality where an eMAR had been implemented 6 months before the first focus groups were performed. The analysis adapted the job‐demand‐control‐support model, by condensing the professionals' experiences into the three categories of demand, control, and support, in alignment with the model. Results: NAs experienced high levels of job demand and low levels of job control. The use of the eMAR limited NAs' ability to control their work, in terms of priorities, content, and timing. In contrast, the nurses described demands as high but manageable, and described having a high level of control. Both professions found the eMar supportive. Conclusion: Nurses and NAs in home healthcare experienced changes in their work environment regarding demand, control, and support when an eMAR was implemented to facilitate delegation of medical administration. In general, nurses were satisfied with the eMAR. However, NAs felt that the eMAR did not cover all aspects of their daily work. Healthcare organisations should be aware of the changes that digitalisation processes entail in the work environment of nurses and NAs in home healthcare. [ABSTRACT FROM AUTHOR]

This article examines the role of digital norm contestation in feminist foreign policy (FFP). It analyzes how states that participate in digital diplomacy are involved in challenging and resisting norms, values and expectations related to feminist positionings in the digital environment. The article presents an analytical framework for the study of digital norm contestation and conducts an empirical case study of Sweden as the first country in the world to brand its foreign policy "feminist." This triggered a process of digital norm contestation, particularly visible in the area of sexual and reproductive health and rights. Three empirical vignettes of digital norm contestation are analyzed. The first example illustrates how the Swedish government was able to exercise global leadership to visually perform and digitally advocate the contestation of the US global gag rule. The second example underlines how the Swedish government harnessed its leadership by connecting it to grassroots contestations of the global gag rule through digital advocacy networks. The third example illuminates how the Swedish government's visit to Iran backfired because of a lost sense of control over visual performative effects in the digital environment. By way of conclusion, we suggest three avenues that can be pursued to further the research agenda on gender, digital norm contestation, and foreign policy. [ABSTRACT FROM AUTHOR]

Aim: To explore spouses' experiences of living with a partner suffering from non‐cardiac chest pain (NCPP). Design: An inductive qualitative study. Methods: Individual interviews (n = 10) were performed with spouses of partners having NCCP and cardiac anxiety. The analysis was performed according to Patton's guide for content analysis of qualitative data. Results: Three categories and seven subcategories were identified. First, 'a feeling of being neglected', where spouses felt ignored by healthcare professionals and excluded by their partners. Secondly, 'a tension between hope and despair' encompassed feelings of faith, support, unpreparedness for chest pain and situational frustration. Lastly, in 'a threat to ordinary life', spouses noted chest pain‐induced changes impacting daily life, finances, leisure and relationships. To conclude, NCCP in partners significantly affects their spouses emotionally and practically. Spouses felt neglected and isolated, oscillating between hope and despair and experiencing faith, powerlessness and frustration. They also faced challenges in daily life and relationships. [ABSTRACT FROM AUTHOR]

Introduction: Health-related quality of life (HRQoL) is essential for human wellbeing, influenced by a complex interplay of factors, and is reported lower in women than men. We aimed to evaluate which factors were the most important for HRQoL in a middle-aged general population. Methods: This was a cross-sectional, multi-centre study of 29,212 men (48%) and women (52%) aged 50–64 in the general population in Sweden. Physical and mental HRQoL (0–100) was assessed using the Short Form 12 questionnaire, and association was evaluated for 356 variables including demographics, lifestyle, symptoms, physiological measurements, and health conditions. Using machine learning, each variable´s importance for HRQoL was measured by an importance score, comparable to effect size, and summarised in 54 factors, in men and women separately. Results: Men and women had similar mean and standard deviation (SD) scores for physical HRQoL (53.4 [SD 8.1] vs 51.4 [9.7]) and mental HRQoL (37.1 [5.0] vs 37.3 [5.4]). The most important factors for physical HRQoL were (importance score) physical activity (40), employment (36), pain (33), sleep (33), and sense of control (26). The most important factors for mental HRQoL were sense of control (18), physical activity (12), depression (12), pain (6), and employment (5). Conclusions: The factors important for HRQoL identified by this study are likely to be amenable to interventions, and our findings can support prioritising interventions. The identified factors need to be a target even before middle-age to lay the foundation for long and happy lives. [ABSTRACT FROM AUTHOR]

Background: Digitally mediated primary healthcare is increasingly influencing working conditions, raising questions about how digitally mediated patient management is experienced. Aim: The aim of this study was to generate insights, through the lens of postphenomenology, into how digitally mediated primary healthcare affects the work and working environment, by gathering perspectives from primary healthcare professionals who regularly manage patient errands through a digital platform. Methods: Two rounds of interviews were conducted with a diversified sample of primary healthcare professionals at a primary healthcare centre. The first round of interviews was conducted during the initial phase of the deployment of a digital platform for patient management, with the second round conducted a year later (n = 24). The interview transcripts were analysed using reflexive thematic analysis. Results: Four themes relating to digitally mediated care work were identified: 'positive feelings towards digitally mediated primary healthcare', 'seeing a positive work atmosphere as a prerequisite for change', 'experiencing increased control over the pace of workflow' and 'reconfiguration of previous problems'. Conclusion and relevance to clinical practice: Building on postphenomenology, our study adds to the understanding of how material and symbolic aspects mutually affect the mediating role of a digital platform for patient management. Thus, the results indicate that the experience of using digitally mediated care processes is conditioned by the discourse towards digitalisation at the workplace and the management's approach to and inclusion of employees in the digital transition of primary healthcare, as well as the usefulness and usability of the digital platform. The findings can inform both practice and policy. [ABSTRACT FROM AUTHOR]

The adoption of intercropping, a sustainable agricultural technology, is limited in Europe. This paper investigates factors driving the intention to intercrop in Sweden. Factors included in the analysis are participation in private certification schemes, interactions with peers and agricultural advisors, attitude, knowledge, innovativeness, perceived intercropping attributes and perceived behavioural control. The first two reflect potential socioeconomic determinants and the last four are possible behavioural drivers. For the first time, the theory of planned behaviour (TPB) and diffusion of innovation theory were integrated to understand farmers' adoption of sustainable farming practices like intercropping. Structural equation modelling was applied to understand the behavioural drivers, whereas logit regression was employed to identify the socioeconomic determinant of adoption intention. The paper highlights the important role of knowledge in fostering intercropping adoption. Knowledge was associated with innovativeness (B = 0.18, p < 0.001) and influenced perceived attribute (B = 0.395, p < 0.001) and attitude (B = 0.268, p < 0.001) towards intercropping. Sufficient knowledge strengthens farmers' confidence in implementing intercropping and subsequently facilitates adoption intention (B = 0.287, p < 0.05). Participation in private certification schemes and interactions with peers, a bonding social capital, also stimulates adoption intention (β = 0.91 and β = 0.70, p < 0.05). Policy implications to support intercropping were discussed. [ABSTRACT FROM AUTHOR]

This study examines recent changes in Swedish regulations for child maintenance in relation to post-separation families with experiences of either intimate partner violence (IPV) or conflict. The reform limited the possibility to rely on the state for maintenance in cases of cooperation difficulties. For IPV cases, the Swedish Social Insurance Agency (SSIA) can function as an intermediary between parents, but such exceptions are made upon assessment and require disclosure of IPV. This study investigates consequences of the maintenance reform and the ways in which it may re-actualize conflict and IPV between separated parents. Data consist of 649 recorded phone calls (~ 55 h) to the SSIA concerning maintenance. Disclosures of post-separation conflict or IPV were found in 132 of these calls; these calls were analyzed using thematic analysis. The maintenance reform's requirement to reinstate contact with a former partner can re-actualize experiences of parental conflict as well as IPV by (a) re-surfacing physical or psychological abuse; (b) continued or accelerated cooperative difficulties; (c) renewed financial control; and (d) 'paper abuse' and new possibilities to display diligence or exert camouflaged control. This can take the form of explicit acts of abuse, anxiety or concern caused by the renewed contact, or being forced to deal with difficult memories. We argue that the Swedish maintenance reform ignores the reality of parental conflicts and IPV by re-actualizing such experiences in a range of ways. [ABSTRACT FROM AUTHOR]

The aim of this qualitative study was to describe experiences of work-related stress among highly stressed municipal employees in rural northern Sweden. We interviewed 15 employees in the municipal sector in rural northern Sweden using a semi-structured guide and subjected the interviews to qualitative content analysis. Under the main theme of Suffering Through Endless Chaos, we summarized four themes: facing incompatible interests and high demands due to lack of time and resources; feeling powerless, trapped, and ignored due to lack of control; feeling insufficient, insecure, and guilty due to challenging relations and high expectations; and struggling with consequences such as health problems, spillover effects on family life, and difficulty coping. Findings from this study suggest the importance of acknowledging suffering among municipal employees in a stressful work environment. An imbalance between job demands and resources is affecting both health and family lives of employees, and also their ability to work. It seems important to improve the work environment through supportive leadership, job control, and reasonable job demands to prevent stress, reduce suffering, and create a healthy organization. [ABSTRACT FROM AUTHOR]

Venous leg ulcer is a recognized condition, affecting people globally. Ulcers mainly affect the elderly and recurrences are not uncommon. There is knowledge about life with venous leg ulcers, but the situation after healing is unexplored. This paper explores and describes meanings of experiences of daily life after healing of a hard-to-heal venous leg ulcer. Lived experiences of 15 individuals with healed hard-to-heal venous leg ulcers generated data for this study. Interviews were recorded for analysis using a reflective lifeworld research approach. An essence emerged, further described by its constituents. Memories of a difficult time with leg ulcer were ever present, in a way becoming part of the self. A striving for control in daily life entailed a struggle to do what was best for the own body. After healing, a new normal emerged in daily life, a reality that encompassed the risk for a new ulcer. The body had changed physically, with marks alongside those from ageing, in a life that still went on. For those who had healed from a venous leg ulcer, life had changed. Even if they referred to life as normal, it was not the same normal as before. [ABSTRACT FROM AUTHOR]

Background: One in ten children have a parent diagnosed with a mental illness by specialised psychiatric services. Severe parental mental illness is a well-established risk factor for children's mental health problems, making the identification and support of these children a public health concern. This study investigated the mental health and family context of children of parents diagnosed with depression, anxiety, or bipolar disorder in this clinical setting. Methods: Parental reports on 87 children aged 8–17 years were analysed. The children's mental health was compared with that of a Swedish population-based sample. Multiple linear regression was used to investigate associations between child mental health and child gender, child age, parent symptoms and social status, family functioning, and perceived parental control. Furthermore, a cumulative risk index explored the effect of multiple risk factors on child mental health. Results: The children reportedly had significantly more mental health problems than did the population-based sample and about one-third had scores above the clinical cut-off. A significant multiple linear regression explained 49% of the variance in child mental health, with lower perceived parental control and younger child age being associated with more child mental health problems. With more reported risk factors, children reportedly had more mental health problems. Conclusions: The results underline the importance of identifying a patient's children and assessing multiple relevant risk factors in the child's life. Furthermore, the results indicate that the needs of younger children and of patients in their parenting role are important to address. [ABSTRACT FROM AUTHOR]

Background: Emergence delirium is a complex behaviour of perceptual disturbances that may occur after general anaesthesia in children. These children often exhibit delusions, confusion, restlessness and involuntary physical activity. They cry and are almost impossible to console. Research has mainly focused on comparing different medication agents in the occurrence of and dealing with emergence delirium. However, less is known about parents' experiences of emergence delirium during the recovery process, and there is hardly any research concerning the children's experiences. Aims: The primary aim of this study was to describe parents' experiences and reflections during their child's emergence delirium behaviour when recovering from anaesthesia. A secondary aim was to describe children's experiences of having been in this condition. Method: A qualitative research approach with thematic analysis was applied. The study was conducted at two county hospitals in southern Sweden. A total of 16 parents and one child were interviewed. Results: Watching their child demonstrate emergence delirium made parents feel as if they were encounteringan incomprehensible scenario. They experienced fear and insecurity and had feelings of powerlessness and guilt. Information and previous experience turned out to offer relief, and being seen by the healthcare staff when they, in their vulnerability, failed to reach or console their child, gave hope and energy. The child confirmed the unexpected and uncontrolled behaviour described by parents. She clearly remembered being 'wild' and out of control. Conclusion: Emergence delirium must be extensively considered in children undergoing general anaesthesia. It is of great importance for healthcare staff to be aware of the parental difficulties it may cause and what is experienced as relieving, such as receiving information and staff members being available, responsive and supportive during the wake‐up period. [ABSTRACT FROM AUTHOR]

Aims and objectives: The aim of this study was to explore experiences of how brief admission influences daily life functioning among individuals with borderline personality disorder (BPD) and self‐harming behaviour. Background: Brief admission (BA) is a crisis nursing intervention designed to reduce long hospitalisations and the risk of suicide. The intention of the intervention is to develop autonomy and to encourage the patient to take responsibility for and control over their own care and treatment. There are studies in the area that target individuals with psychosis and bipolar disorders, but no previous studies have been found examining how BA impacts upon daily life functioning among people with BPD who self‐harm. Design: A descriptive qualitative design was chosen. Methods: Data were collected using qualitative individual interviews with 16 patients with BPD and self‐harming behaviour who had been assigned to BA. The data were analysed using conventional content analysis. The study was conducted in accordance with COREQ guidelines. Results: The results show that BA was perceived as a functioning nursing intervention that promoted self‐determination and self‐care. This contributed to increased security in daily life. BA made it possible for individuals to maintain everyday routines, employment and relationships more easily. Conclusions: Our findings suggest that BA was experienced to have a positive impact on daily life functioning. Relevance to clinical practice: Brief admission enabled the balance of power to be shifted from the nurse to the patient, and provides conditions for patients to take responsibility for their mental condition and to become aware of early signs of deterioration, in line with the basic ideas of person‐centred care. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate the psychometric properties of a Swedish version of the Impaired Control Scale. Impaired control (IC) over alcohol consumption is a core symptom of alcohol use disorder and a predictor of treatment outcome, but measures of IC are not well utilised in clinical practice. Methods: The study comprised 250 individuals from a randomised controlled trial conducted at an adult outpatient addiction clinic in Sweden. The statistical analyses concern dimensionality, convergent and divergent validity, reliability, measurement invariance and sensitivity to change. Results: Regarding dimensionality, a principal component analysis of the standardised residuals from a Rasch model indicated some evidence of further dimensions underlying the responses in the Failed Control (FC) and Perceived Control (PC) parts. Two parallel items (12 and 22 respectively) seemed to drive potential multidimensionality. When these items were excluded, goodness of fit to one-dimensional models was improved. Tests of convergent and divergent validity showed that failed control had the strongest associations to impaired control and alcohol use disorder while the attempted control part was not associated with the construct of impaired control or alcohol use disorder. Conclusion: The present results show that the FC part is the most valid measure of the underlying construct of IC. In addition, FC had close to a large effect in regard to sensitivity to change. This suggests that the FC part has potential utility for use as an assessment and evaluation tool of treatment effect on impaired control of drinking. [ABSTRACT FROM AUTHOR]

This article analyzes lay people's use of nutritionistic discourse in written correspondence with the Swedish Food Agency, an authority responsible for dietary advice. Examining 60 food related written digital messages, we apply a critical discourse analysis to parse the lexical items and grammar people use when constructing "food" in scientific terms. The findings show how message writers place nutrients at the discursive center. Message writers' grammatical constructions instrumentalize food and eating. This is reinforced by the message writers' frequent use of terms that indicate preciseness, such as numbers and amounts. Messages therefore emphasize the what, but not the how, of eating, implying a focus on food as subject to regulation and control. As such, eating is discursively reduced to an act of ingesting nutrients that can be decontextualized and managed in isolation--as entities to increase or avoid separately. These discursive features preclude the conceptualization of food choice and eating as subjective experiences of feelings, taste, and tradition. [ABSTRACT FROM AUTHOR]

Young unaccompanied refugees come in contact with acute psychiatric care due to pre‐existing mental health conditions as well as stressful and traumatic experiences before, during, and after migration. Previous research on nurses' experiences of caring for refugees has primarily reported on difficulties related to cultural differences and communication and how nurses might distrust refugees. This study aimed to describe registered nurses' experiences of caring for young unaccompanied refugees in acute psychiatric care. Semi‐structured interviews with ten nurses were analysed using a method for qualitative content analysis. Data were collected in Sweden during 2019 and 2020. Results describe nurses' experiences of caring for young unaccompanied refugees in acute psychiatric care in one theme: learning your limits and three sub‐themes: feeling powerless but doing what you can; taking a stance in a politicized environment; and being frustrated and in need of support. Findings highlight the potential and limitations of mental health nursing, the importance of reflection and peer support, and the importance of viewing the roles and responsibilities of mental health nurses and nursing in a societal context. These findings suggest that nurses can make a difference for young unaccompanied refugees in acute psychiatric care. However, in doing so, nurses need support in realizing what they can and cannot achieve. The study is reported in accordance with the COREQ guidelines. [ABSTRACT FROM AUTHOR]

Purpose: In this qualitative study we explored how young women living in Sweden with ethnic and cultural roots in the Middle East and East Africa comply with or resist so-called honour norms and how they perceive that these norms affect their living conditions. Method: In depth interviews were performed with 14 young women. The majority were between 21 and 32 years of age with a mean age of 24. All interviews were transcribed verbatim and a grounded theory approach was used. To reflect the diversity in women's experiences, the grounded theory approach was conducted from a feminist perspective to transform women's personal narratives to a larger social context. Results: We analysed the core category "Honorable women in becoming" as the central emerging phenomenon related to categories about structural and individual control of women, the women's adjustment and resistance, and the continuum of severe consequences and violence that they experienced in their struggle for autonomy. Conclusion: Simone de Beauvoir's feminist theory about women as "the other" was an inspiration and gave us valuable input to highlight women's experiences and situations from a perspective of gender, power, and oppression. [ABSTRACT FROM AUTHOR]

BACKGROUND: The complex position of a first line manager is characterized by heavy workload and contradictory demands. Little is known about how first line managers experience demand and control in their work. OBJECTIVES: The aim of this study was to explore experiences of demand and control among first line managers within psychiatric and addiction care. METHOD: In the present study, interviews with ten managers in for-profit psychiatric and addiction care in Sweden were analyzed with a phenomenographic approach. RESULTS: The managers experiences of demand and control implied varied and extensive responsibilities for a wide range of professions; regulation by organizational, economic, and political frameworks; creating balance in their work; and handling the emergence and consequences of acute crisis. These experiences of demand and control involved high and contradictory demands together with coexisting high and low levels of control. Many of their work characteristics could be described in terms of both demand and control. CONSLUSION: The first line managers experiences of demand and control are more complex than implied by the job demand control theory. Our results suggest that the organizational position and branch should be considered when identifying health hazards in the work environment of first line managers. [ABSTRACT FROM AUTHOR]

Aim: Traditional methods used when managing self‐harm in a psychiatric inpatient setting tend to infringe on the autonomy of the individuals receiving treatment and are often experienced as practically and emotionally challenging by care providers. Therefore, we examined care providers' experiences of an alternative method negotiating self‐harm abstinence agreements, which can be viewed as a form of positive risk taking. Design: A qualitative approach using semi‐structured interviews with twelve mental health professionals. Methods: Thematic analysis of the interviews. Results: Five themes emerged; "No‐harm agreements versus constant observation and coercion," "No‐harm agreements to promote independence and collaboration," "No‐harm agreements' effect on ward safety," "Ambiguity surrounding the no‐harm agreements" and "Ethical complexities of the no‐harm agreements." These indicated perceived positive effects on the therapeutic relationship, the individuals' autonomous functioning and the ward environment, but also practical and ethical difficulties. [ABSTRACT FROM AUTHOR]

Occupational therapists with less than 10 years of work experience have been shown to be at higher risk of work-related stress. There is a need for further research on the level of job strain they perceive. To investigate the perceived level of job strain among Swedish occupational therapists with less than 10 years of work experience and differences between groups who have worked for 0–5 years and 6–10 years. In this cross-sectional study, a web-based survey was sent to 345 occupational therapists with less than 10 years of work experience, with 252 responding. Data was collected using the Swedish Demand-Control-Support Questionnaire and questions on job strain and sociodemographics. The participants scored 19.68 points on the control scale and 20.01 points on the support scale, indicating high levels of control and support, and 13.33 points on the demand scale (high demand ≤ 14 points). Twelve percent worked in high strain jobs. Most (75%) worked in low strain and active jobs. The participants reported low levels of job strain. However, to prevent mental health problems, employers need to identify those in active jobs to ensure that they have time to exercise control over their work situation. [ABSTRACT FROM AUTHOR]

Background: Few studies have focused on how older persons living in nursing homes perceive their last period of life. Furthermore, previous research on older persons' perceptions of death and dying is limited. Hence, there is an urgent need to explore their experiences during their final period in life. Aim: To explore thoughts about death and dying and experiences of care in end-of-life among older persons living in nursing homes. Methods: This study employed a qualitative approach including individual interviews with 36 older persons living in Swedish nursing homes. Questions related to quality of life; physical health; thoughts about death, dying, and the future; and experiences related to the living condition and environment were asked. The interview transcripts were analysed through content analysis. The study was approved by the Regional Ethics Review Board (reference number: 2015/4). Results: The analysis resulted in the identification of three main thematic categories: The unavoidable and unknown end of life, Thoughts on control and Living your last period of life at a nursing home. The older persons did not fear death itself but had some worries about dying. Spending the last stage of life at a nursing home contributed to different thoughts and feelings among the older persons. With a few exceptions, older persons characterized life at the nursing home as boring and felt they were surrounded by people who did not belong there. Conclusions: This study indicates a need for older persons to talk about death, dying and end-life issues. Furthermore, this study highlighted that the co-residence of cognitively healthy persons and persons with dementia in the same ward adversely affected cognitively healthy persons. This situation resulted in there being not enough time to both handle the care needs of persons with dementia and have the conversations that cognitively healthy persons desired, such as conversations about thoughts about existence, that could have improved their quality of life. Trial registration: NCT02708498 Date of registration 16 February 2016. [ABSTRACT FROM AUTHOR]

While it is becoming more common to hear calls for a human rights-based approach (HRBA) to health, documented efforts to apply the approach in practice remain scant. This paper presents a review of a pilot study applying an HRBA to psychiatric care in Gothenburg, Sweden. Based on the reflections of some involved in the pilot, and on the evaluation carried out, it presents the context, process, effects, and lessons learned. In the paper, we structure our experiences of an HRBA around the United Nations' guiding principles of dignity and empowerment, equality and non-discrimination, participation and inclusion, accountability, and transparency. We discuss challenges encountered during the project, such as realizing meaningful participation and challenging the hierarchies of different professions within care. We also discuss successes, such as contributing to an overall strategic goal to eliminate all coercive measures in psychiatric care. We then offer our reflections, as the core team involved in the pilot, on how to make an HRBA sustainable in a large organization and provide practical recommendations based on our experiences. [ABSTRACT FROM AUTHOR]

This article applies the concepts of place and space to understand youth and their engagement in risky behavior, such as drunkenness. It is based on the prolonged engagement with 23 underage youth coming from smaller municipalities in the south of Sweden. The study was comprised of semi-structured interviews, field visits, and observations at sites relevant for youths. In the stories narrated by youth, drunkenness is no longer an ad hoc activity conducted somewhere at the margins of society. The construction of drinking spaces was accomplished through highly managed, monitored, and organized practices, such as sending out invitations in advance, planning how much alcohol to drink, designating drivers, and securing transport means. Crucial to this was that spaces were products of relations existing between various youth, with no adults present. Spaces of drinking changed as those who participated in their construction changed. In addition, certain rules and codes of conduct (e.g. taking care of friends who drunk too much) were enforced to assure that the constructed spaces provided a sense of safety and enabled having fun. We conclude this article by arguing that a focus on place and space brings forward vital aspects in understanding the role of transforming party spaces that would otherwise remain obscure to social work knowledge and practice. [ABSTRACT FROM AUTHOR]

Most older persons moving to a nursing home need to receive assisted bodily care, which means being in a position of vulnerability. However, few studies have explicitly focused on the meanings of receiving assisted bodily care from the older persons' perspective. This study aimed to elucidate meanings of receiving assisted bodily care, as narrated by older persons living in a nursing home. Twelve men and women, aged 80 or older, living in a Swedish nursing home, participated in the study. Data were generated by narrative interviews and analysed with a phenomenological‐hermeneutical method. The regional ethics committee approved the study. In the analysis, one main theme emerged: 'Assenting to exposedness'. This theme comprised five themes, 'To have hope in hopelessness', 'To relinquish one's body into others' hands', 'To be between power and powerlessness', 'To oscillate between one's own responsibility and demands', 'To be in an ongoing interaction', and ten subthemes. In conclusion, receiving assisted bodily care means to be exposed, but not passively. Rather, it means to be self‐determinant for as long as possible, to perceive the body as lived. When the body must be relinquished to others, it might be objectified, leading to care‐suffering. To avoid this, the older persons use a certain competence, acquired through life, to decide when to take action or when to assent. However, this is but one of the several possible interpretations, which may be considered a limitation. [ABSTRACT FROM AUTHOR]

• Subjective norm, farmers perceived social pressure, influence mastitis control. • Farmers' perception of being able to control the mastitis situation decides which preventive actions are used. • Understanding how to affect farmers behavior in their usage of preventive actions can have positive effects on animal health and welfare. Mastitis control options (MCOs) are management actions that are adopted to prevent mastitis in dairy herds. In this study, the psychological constructs attitude, subjective norms and perceived behavioral control are used to explain farmers' adoption of MCOs. So far, little research has used psychological constructs to explain adoption of MCOs. Based on recommendations by a Swedish dairy association (Växa) aimed at farmers, a total of 15 different management areas, representing MCOs for contagious and environmental bacteria, were used to characterize adoption behaviors. A total of 286 Swedish full-time farmers specializing in dairy production participated in the survey. Four different farmer groups were identified through a cluster analysis of similarities in how farmers adopted MCOs together with data on bulk milk somatic cell count and subjectively evaluated somatic cell counts on the farms. Regression analyses were performed to test whether the psychological constructs could explain differences in adoption across the MCO groups. Results revealed that farmers' decisions about which set of mastitis control options to adopt as preventive actions were explained by the farmers' perceived behavioral control of the situation and by differences in subjective norm. The attitude construct did not contribute to predicting the adoption of mastitis control options. Results suggest that work aimed at implementing MCOs should be complemented by programs specifically designed to improve the ability of farmers to use and/or combine MCOs to both alleviate and prevent mastitis. They also suggest that there is little to gain from programs aimed at fostering attitudes to prevent mastitis. We interpret the findings as indicating a need to strengthen perceived behavioral control as well as subjective norms among Swedish farmers' regarding their preventive work with mastitis. Understanding how to affect farmers' behavior, and thus reducing and controlling mastitis, will have positive effects on animal health and welfare in general. [ABSTRACT FROM AUTHOR]

This study focused on the factor structure of the victimization form of the revised Controlling Behaviors Scale (CBS-R). Data from 1,218 women and men were analyzed in the study. Results of confirmatory factor analysis (CFA) failed to find support for the proposed five-factor structure of the scale, as the items on the scale were better represented by one common factor. In addition, when examining if controlling behaviors are distinct from psychological aggression, the CFA indicated that the items on the CBS-R are clearly distinguishable from the items on the psychological aggression (as measured with the subscales of the revised Conflict Tactic Scales [CTS2]), and that this holds for both males and females. Implications for the general use of the CBS-R and for use in conjunction with psychological aggression and physical aggression in intimate partner violence were discussed. [ABSTRACT FROM AUTHOR]

This article investigates the nature of honor-related domestic violence as experienced by 11 young female victims (aged 16–20) with non-Swedish-born parents. It examines what forms of violence are involved and how they are related to each other and looks at the differences and similarities to non-honor-related domestic violence. Qualitative, individual interviews were made with young women who, when in contact with counselors, mid-wives or social workers, said that they were living with restrictions over their social life and sexuality with some level of control imposed by another person. Accordingly, it is young women's subjective assessment of their experience which defined their inclusion in this study. The analysis has been a recursive process with a theory-oriented approach that uses Bourdieu's concept of symbolic violence as a theoretical lens. The participants belonged to patriarchal families in a particular cultural/religious community and lived under various types of coercive control. For the participants, the core concept of the family norms was twofold: honor and firm demands for chastity. There was a strong link between the restrictions they experienced and their vulnerability to various forms of violence, alongside accounts of strong emotional ties between father and daughter, in most cases. The participants' scope for action was affected irrespective of they were physically abused or not. The findings contribute to an initial understanding of how nonviolent controlling behaviors affect young women's scope for action and highlight daughters' vulnerable situation in a patriarchal family. [ABSTRACT FROM AUTHOR]

Objective: There is a paucity of data on disordered eating among adoptees. The aim of the present study was to explore the prevalence of symptoms of disordered eating and body image concerns among international adoptees in a large representative community survey on health‐related behaviours. Method: Combining survey data from the Stockholm Public Health Cohort and Swedish population data, adult international adoptees were compared with total participant data to assess differences in disordered eating and body dissatisfaction. Results: International adoptee women displayed significantly higher levels of self‐induced vomiting, loss‐of‐control eating, food preoccupation, underweight, and wish for thinness compared with nonadoptee women, albeit with small or very small effect sizes. No significant differences were found in terms of mean body mass index, cognitive restraint, or emotional eating. Conclusion: International adoptee women were disproportionally affected on several measures of disordered eating, although the magnitude of these differences were generally small in absolute terms. [ABSTRACT FROM AUTHOR]

The focus of the current study was to explore nursing home staff 's understanding and how they approach family caregivers' existential life situations when caring for individuals with dementia. A qualitative interview study was conducted with 20 nursing staff in two nursing homes in northern Sweden. Face-to-face interviews were analyzed using interpretive content analysis. One overarching theme with three themes and nine subthemes comprised the findings. The themes describe how nursing staff were "in between" when they cared for individuals with dementia and encountered family caregivers' existential life situations. Nurses acted as advocates and safeguarded family caregivers via dialogues and interactions. Nurses were supporters and by "being in between" they eased family caregivers' feelings of powerlessness in relation to dying and death. "Being in between" may give nurses a deeper understanding of family caregivers' existential needs, thus increasing family caregivers' well-being. [ABSTRACT FROM AUTHOR]

Background: As treatment has improved, patients with heart failure live longer, and the care mostly takes place at home with partners providing the main assistance. Perceived control over heart failure is important in managing self-care activities to maintain health in patients and their family. Depressive symptoms are associated with impaired health status in patients with heart failure and their family. However, there is limited knowledge about how depressive symptoms affect the relationship between health status and perceived control over heart failure in patients with heart failure and their cohabiting partners. Aim: The aim of this study was to examine whether the relationship between perceived control and health status (i.e. mental and physical) was mediated by depressive symptoms in patients with heart failure and their partners. Methods: In this secondary data analysis, we included 132 heart failure patients and 132 partners who completed measures of depressive symptoms (the Beck depression inventory II), perceived control (the control attitude scale), and physical and mental health status (the short form-36) instruments. The mediation effect of depression was examined using a series of multiple regression in patients and their family caregivers separately. Results: We found a mediator effect of depressive symptoms in the relationship between perceived control and mental health status in both patients and partners. The relationship between perceived control and physical health status was mediated by depressive symptoms in the patients, not in the partners. Conclusion: Efforts to improve self-care management and maintenance by targeting perceived control may be more effective if depressive symptoms are also effectively managed. [ABSTRACT FROM AUTHOR]

This study is about the vulnerability of parents to adult children with drug problems. The study is based on a self-reporting questionnaire (n = 687) distributed to parents in Sweden via family member organizations, treatment centers, and online communities. Most parents reported extensive negative consequences on relationships, social life, and mental health due to their children’s drug problems. Most parents also experienced strong feelings of powerlessness, grief, guilt, and shame. Many parents reported a negative impact on their economy and work ability. In general, fathers claimed to feel less of a negative impact than mothers. A more severe drug problem and life situation for the child was associated with a greater negative impact for the parents. Many parents experienced difficulties in securing adequate help both for their child and for themselves. The study shows the need for increased support efforts for this parent group. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Intensive care unit (ICU) discharges are challenging practices that carry risks for patients. Despite the existing body of knowledge, there are still difficulties in clinical practice concerning unplanned ICU discharges, specifically where there is no step‐down unit. Aims and objectives: The aim of this study was to explore general ward nurses' experiences of caring for patients being discharged from an ICU. Design and methods: Data were collected from focus groups and in‐depth interviews with a total of 16 nurses from three different hospitals in Sweden. An inductive qualitative design was chosen. Findings: The analysis revealed three themes that reflect the challenges in nursing former ICU patients: a vulnerable patient, nurses' powerlessness and organizational structure. The nurses described the challenge of nursing a fragile patient based on several aspects. They expressed feeling unrealistic demands when caring for a fragile former ICU patient. The demands were related to their own profession and knowledge regarding how to care for this group of patients. The organizational structure had an impact on how the nurses' caring practice could be realized. This evoked ethical concerns that the nurses had to cope with as the organization's care guidelines did not always favour the patients. Conclusions: The structure of the organization and its leadership appear to have a significant impact on the nurses' ability to offer patients the care they need. Relevance to clinical practice: This study sheds light on the need for extended outreach services and intermediate care in order to meet the needs of patients after the intensive care period. [ABSTRACT FROM AUTHOR]

The aim of this study was to elucidate the meaning of the lived experience of lifestyle changes as perceived by people with severe mental illness (SMI). People with SMI who have experience in managing lifestyle changes were interviewed (n= 10). The interviews were analyzed with a phenomenological hermeneutic approach. The findings reveal three themes: (1) struggling with inner and outer limitations, (2) on one's own but together with others and (3) longing for living a life in harmony. The meaning of lifestyle changes can be understood as a person's internal and external endeavors to make well-considered decisions about lifestyle changes. Support should focus on strengthening the person's self-efficacy and should be based on the person's experiences. [ABSTRACT FROM AUTHOR]

The increase in the use of medical devices in palliative home care requires that patients and next-of-kin feel secure. Therefore, the aim was to describe medical technology’s impact on the sense of security for patients, next-of-kin and district nurses. Deductive content analysis was conducted on data from three previous studies, using the theoretical framework ‘palliative home care as a secure base’. The use of medical technology was shown to have an impact on the sense of security for all involved. A sense of control was promoted by trust in staff and their competence in managing the technology, which was linked to continuity. Inner peace and being in comfort implied effective symptom relief facilitated by pain pumps and being relieved of responsibility. Health care professionals need to have practical knowledge about medical technology, but at the same time have an awareness of how to create and maintain a sense of security. [ABSTRACT FROM AUTHOR]

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Background Resilience has been shown to be protective against alcohol use disorders (AUDs), but the magnitude and nature of the relationship between these 2 phenotypes are not clear. The aim of this study was to examine the strength of this relationship and the degree to which it results from common genetic or common environmental influences. Methods Resilience was assessed on a 9-point scale during a personal interview in 1,653,721 Swedish men aged 17 to 25 years. AUD was identified based on Swedish medical, legal, and pharmacy registries. The magnitude of the relationship between resilience and AUD was examined using logistic regression. The extent to which the relationship arises from common genetic or common environmental factors was examined using a bivariate Cholesky decomposition model. Results The 5 single items that comprised the resilience assessment (social maturity, interest, psychological energy, home environment, and emotional control) all reduced risk for subsequent AUD, with social maturity showing the strongest effect. The linear effect by logistic regression showed that a 1-point increase on the resilience scale was associated with a 29% decrease in odds of AUD. The Cholesky decomposition model demonstrated that the resilience-AUD relationship was largely attributable to overlapping genetic and shared environmental factors (57 and 36%, respectively). Conclusions Resilience is strongly associated with a reduction in risk for AUD. This relationship appears to be the result of overlapping genetic and shared environmental influences that impact resilience and risk of AUD, rather than a directly causal relationship. [ABSTRACT FROM AUTHOR]

Although much is known about the impact of intimate partner violence on children, few empirical studies have linked children's experiences to typologies. This qualitative study, based on interviews with children 8-12 years of age living at women's shelters in Sweden, explores how children describe the nature of the violence they have been exposed to with the aim of identifying patterns in the children's experiences. The typologies developed by Johnson and colleagues and by Holtzworth-Munroe and colleagues are used as an analytical framework for analysis. Three main types of children's experiences of intimate partner violence were identified: 'Obedience-Demanding Violence,' 'Chronic and Mean Violence,' and 'Parenthood-Embedded Violence.' These the types can improve our understanding of the complex variety of children's experiences of parental IPV by acknowledging how from children's perspectives, experiences of IPV are closely connected to the perpetrator being their parent. The study provides examples of three different strategies that have implications for the factors that social workers may want to address when making judgments about custody, place of residence, and contact. [ABSTRACT FROM AUTHOR]

Introduction Emotional distress in patients with chronic heart failure ( CHF) predicts mortality, hospital readmission and quality of life. The patient's avoidant coping style and beliefs about the disease have been linked to emotional distress in CHF. However, the pattern and transmitting effects of these variables are indefinite. Aim This study aimed to examine the links between and the potential mediating role of illness perceptions and avoidant coping style on depression and anxiety in patients with CHF. Method Self-assessment data from 103 patients with CHF were subjected to path analysis in two hypothesised models. The outcome measures were coping styles, illness perception, anxiety and depression. Results Avoidant coping had a direct adverse effect on anxiety and depression. The perception of symptom burden and personal control, significantly mediated the effect between avoidant coping and anxiety and depression. Conclusions Avoidant coping style appears to influence not only emotional distress, but also a malignant symptom perception and low sense of control over the illness. [ABSTRACT FROM AUTHOR]

Background: Ethically difficult situations are frequently encountered by healthcare professionals. Moral case deliberation is one form of clinical ethics support, which has the goal to support staff to manage ethical difficulties. However, little is known which difficult situations healthcare teams need to discuss. Aim: To explore which kinds of ethically difficult situations interprofessional healthcare teams raise during moral case deliberation. Research design: A series of 70 moral case deliberation sessions were audio-recorded in 10 Swedish workplaces. A descriptive, qualitative approach was applied, using thematic content analysis. Ethical considerations: An advisory statement specifying no objections to the study was provided from an Ethical Review Board, and consent to be recorded was assumed by virtue of participation in the moral case deliberation. Findings: Three themes emerged: powerlessness over managing difficult interactions with patients and next-of-kin, unease over unsafe and unequal care, and uncertainty over who should have power over care decisions. The powerlessness comprised feelings of insufficiency, difficulties to respond or manage patient’s/next-of-kin’s emotional needs or emotional outbursts and discouragement over motivating patients not taking responsibility for themselves. They could be uncertain over the patient’s autonomy, who should have power over life and death, disclosing the truth or how much power next-of-kin should have. Discussion: The findings suggest that the nature of the ethically difficult situations brought to moral case deliberations contained more relational-oriented ethics than principle-based ethics, were permeated by emotions and the uncertainties were pervaded by power aspects between stakeholders. Conclusion: MCD can be useful in understanding the connection between ethical issues and emotions from a team perspective. [ABSTRACT FROM AUTHOR]

Grandparents whose grandchildren are exposed to domestic violence are faced with some unique challenges in their grandparenting, which have thus far been little discussed in research. This paper discusses the narratives of 10 Swedish grandparents whose grandchildren have been exposed to violence towards their mother. The aim was to explore grandparents' narrations of their responses in the face of violence, and their understanding of the role they play in their grandchildren's social networks. Two significant responses are discussed: ‘being there’ and ‘acknowledging the independence and self‐determination of the adult children’. Grandparents experienced these responses as contradictory and felt powerless when it came to their possibilities to protect their grandchildren. The paper suggests that grandparents could be a resource for domestic violence services, and social work practice needs to assess the roles of grandparents of children exposed to domestic violence. Social workers should consider the challenges these grandparents are facing and what support they may need in order to support their grandchildren. [ABSTRACT FROM AUTHOR]

BackgroundMany people ageing with intellectual disabilities (ID) age in place in group homes. Participation is a central concept in support and service to people with ID, but age is often a determining factor for participation among this group. Choice and control are dimensions of participation.AimThe aim of this article is to explore how choice and control in the everyday life of people ageing with ID is expressed and performed in the group home’s semi-private spaces.Material and methodsParticipant observations and interviews with residents and staff were conducted in four different group homes in Sweden that had older residents.ResultsFour categories were found that can be understood as aspects of choice and control in the group home’s semi-private spaces in the everyday life of people ageing with ID. These categories included aspects such as space and object, time and routines, privacy, and a person-centred approach.Conclusion and significancePeople ageing with ID are vulnerable when it comes to maintaining choice and control in various situations in the home’s semi-private spaces. It is argued that occupational therapists should include this occupational arena in their evaluations and interventions for people ageing with ID. [ABSTRACT FROM PUBLISHER]

Background: There has been considerable interest in normative ethics regarding how and when coercive care can be justified. However, only a few empirical studies consider how professionals reason about ethical aspects when assessing the need for coercive care for adults, and even less concerning children and adolescents. The aim of this study was to examine and describe how professionals document their value arguments when considering the need for coercive psychiatric care of young people.Methods: All 16 clinics that admitted children or adolescents to coercive care during one year in Sweden were included in the study. These clinics had a total of 155 admissions of 142 patients over one year. Qualitative content analysis with a deductive approach was used to find different forms of justification for coercive care that was documented in the medical records, including Care Certificates.Results: The analysis of medical records revealed two main arguments used to justify coercive care in child and adolescent psychiatry: 1) the protection argument - the patients needed protection, mainly from themselves, and 2) the treatment requirement argument - coercive care was a necessary measure for administering treatment to the patient. Other arguments, namely the caregiver support argument, the clarification argument and the solidarity argument, were used primarily to support the two main arguments. These supportive arguments were mostly used when describing the current situation, not in the explicit argumentation for coercive care. The need for treatment was often only implicitly clarified and the type of care the patient needed was not specified. Few value arguments were used in the decision for coercive care; instead physicians often used their authority to convince others that treatment was necessary.Conclusions: One clinical implication of the study is that decisions about the use of coercive care should have a much stronger emphasis on ethical aspects. There is a need for an ethical legitimacy founded upon explicit ethical reasoning and after communication with the patient and family, which should be documented together with the decision to use coercive care. [ABSTRACT FROM AUTHOR]

Parents of young adults with mental illness may face a continued demand for support, even though their children have reached the age of majority. The aim of this study was to explore relatives’ experiences of parenting a young adult with mental illness in transition to adulthood. Individual interviews were conducted and analysed according to Grounded Theory. The results showed that relatives experienced powerlessness and a sense of inescapable duty with limited possibilities to be relieved. With a family nursing approach, relatives can be supported and, when the young adults’ needs of care are met, they can be relieved from their burden of responsibility. [ABSTRACT FROM AUTHOR]

This study aims at exploring and interpreting men's experiences of intimate partner violence (IPV) in the light of selected current theoretical contributions to the field, with an emphasis on Michael P. Johnson's violence typology. The material consisted of twenty interviews with men who self-identified as having been subjected to IPV. Men generally did not consider physical violence to be threatening when it was perpetrated by women. They were also not subjected to the multiple control tactics that define the intimate terrorism category of Johnson's violence typology, lending support to the argument that women's and men's experiences of IPV differ in opposite-sex relationships. Furthermore, our findings encourage the integration of structural inequalities related to gender and sexuality in analyses of men's experiences of IPV. [ABSTRACT FROM AUTHOR]

Background: Providing nursing care for patients with end-stage renal disease entails dealing with existential issues which may sometimes lead not only to ethical problems but also conflicts within the team. A previous study shows that physicians felt irresolute, torn and unconfirmed when ethical dilemmas arose. Research question: This study, conducted in the same dialysis care unit, aimed to illuminate registered nurses’ experiences of being in ethically difficult situations that give rise to a troubled conscience. Research design: This study has a phenomenological hermeneutic approach. Participants: Narrative interviews were carried out with 10 registered nurses working in dialysis care. Ethical considerations: The study was approved by the Ethics Committee of the Faculty of Medicine, Umeå University. Results: One theme, ‘Calling for a deliberative dialogue’, and six sub-themes emerged: ‘Dealing with patients’ ambiguity’, ‘Responding to patients’ reluctance’, ‘Acting against patients’ will’, ‘Acting against one’s moral convictions’, ‘Lacking involvement with patients and relatives’ and ‘Being trapped in feelings of guilt’. Discussion: In ethically difficult situations, the registered nurses tried, but failed, to open up a dialogue with the physicians about ethical concerns and their uncertainty. They felt alone, uncertain and sometimes had to act against their conscience. Conclusion: In ethical dilemmas, personal and professional integrity is at stake. Mistrusting their own moral integrity may turn professionals from moral actors into victims of circumstances. To counteract such a risk, professionals and patients need to continuously deliberate on their feelings, views and experiences, in an atmosphere of togetherness and trust. [ABSTRACT FROM AUTHOR]

The aim of this study was to explore the barriers experienced by doctoral nursing students during their research studies. An additional aim was to explore the strategies used to overcome these barriers. It can be a very challenging endeavour for doctoral nursing students to complete their research studies. During their research studies, doctoral students encounter various barriers that impede the progress of their studies. The study design was qualitative, and data were collected through individual interviews with seven doctoral nursing students at one university in Sweden between September and the end of November 2014. The data revealed seven themes illustrating barriers and strategies used by the doctoral nursing students to overcome these barriers: 1) difficulties in defining concepts, 2) intellectual struggles with qualitative analysis, 3) lack of control during the recruitment process, 4) missing a more research-oriented environment, 5) interruption to study focus when combining research and work, 6) lack of motivation, and 7) feeling powerless during supervision. In conclusion, this study illustrates the importance of facilitating good relationships between doctoral nursing students, their supervisors and faculty as a possible way of reducing barriers during research studies. These findings could be of help in the development of better learning environments for doctoral nursing students. [ABSTRACT FROM AUTHOR]

Background: The four-item Control Attitudes Scale (CAS) was developed to measure control perceived by patients with cardiac disease and their family members, but extensive psychometric evaluation has not been performed. Objective: The aim was to translate, culturally adapt and psychometrically evaluate the CAS in a Swedish sample of implantable cardioverter defibrillator (ICD) recipients, heart failure (HF) patients and their partners. Methods: A sample (n=391) of ICD recipients, HF patients and partners were used. Descriptive statistics, item-total and inter-item correlations, exploratory factor analysis, ordinal regression modelling and Cronbach's alpha were used to validate the CAS. Results: The findings from the factor analyses revealed that the CAS is a multidimensional scale including two factors, Control and Helplessness. The internal consistency was satisfactory for all scales (a=0.74-0.85), except the family version total scale (a=0.62). No differential item functioning was detected which implies that the CAS can be used to make invariant comparisons between groups of different age and sex. Conclusions: The psychometric properties, together with the simple and short format of the CAS, make it to a useful tool for measuring perceived control among patients with cardiac diseases and their family members. When using the CAS, subscale scores should be preferred. [ABSTRACT FROM AUTHOR]

Rape is a widespread but underreported problem among women. In this article I explore the complexities surrounding the fine line between consensual and nonconsensual sexual intercourse, by studying a rape through which a young woman was infected with HIV. I provide an analysis of how to understand and interpret this episode by applying a gender perspective based on patriarchy—namely, women's submissive position in heterosexual situations compared with men—and the concept of agency, that is, the individual's own decision-making ability, own choices, and different courses of action available, to outline the frame of action available to the informant. The inclusion of agency and a gender perspective offers new dimensions on how to understand and give meaning to narratives that are seldom told. [ABSTRACT FROM AUTHOR]