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Encountering racism is burdensome and meeting it in a healthcare setting is no exception. This paper is part of alarger study that focusedonunderstandingandaddressingracismin healthcare in Sweden. In the paper, we draw on interviews with 12 ethnic minority healthcare staff who described how they managed emotional labor in their encounters with racism at their workplace. Data were analyzed using thematic analysis. The analysis revealed that experienced emotional labor arises from two main reasons. The first is the concern and fear that ethnic minority healthcare staff have of adverse consequences for their employment should they be seen engaged in discussing racism. The second concerns the ethical dilemmas when taking care of racist patients since healthcare staff are bound by a duty of providing equal care for all patients as expressed in healthcare institutional regulations. Strategies to manage emotional labor described by the staff include working harder to prove their competence and faking, blocking or hiding their emotions when they encounter racism. The emotional labor implied by these strategies could be intense or traumatizing as indicated by some staff members, and can therefore have negative effects on health. Given that discussions around racism are silenced, it is paramount to create space where racism can be safely discussed and to develop a safe healthcare environment for the benefit of staff and patients.

Background: A majority of persons with dementia in Sweden live in their own homes and are often cared for by family members. Caring for a family member may be a positive experience. It may, however, also be a negative experience as symptoms like disturbing behavior and delusions may be difficult to encounter. The burden of being a family caregiver has been shown to affect the caregivers’ quality of life. Objective: To explore stakeholders’ perspectives on a potential mobile application through which family caregivers could be supported by healthcare professionals in caring for a person with dementia living at home. Method: Eight individual interviews with family caregivers and a focus group with eight healthcare professionals specialized in dementia care were analyzed using content analysis method. Results: The findings suggest that a mobile application can support family caregivers to meet their own needs in terms of finding structure in everyday life, how to get information and support in their own pace, and how to care for themselves. The findings also suggest the necessity of accessing relevant contact networks to be supported in the ability to care for a family member with dementia. Conclusion: Healthcare and social services mediated support provided through user-friendly mobile application has the potential to support family caregivers both in taking care of a person with dementia and caring for themselves. Moreover, it is important that the information provided to family caregivers is personalized according to the needs of the family caregivers as the family member’s dementia advances.

Background Globally, family members account for the main source of caregiving of persons with dementia living at home. Providing care to family members with dementia often has negative health consequences for caregivers such as stress, depression and low quality of life. Yet, formal support for family caregivers (FCs) is limited. Telehealth technology has the potential to provide health care and social support to FCs. This study aims to assess the effectiveness of providing support by healthcare professionals (HPs) through a mobile app in reducing stress, depressive symptoms and loneliness, and improving mental health and quality of life of FCs of persons with dementia. Methods Using a pragmatic intervention design, this study will use pre- and post-intervention assessment to evaluate the effectiveness of the proposed intervention in a sample of 78 FCs of persons with dementia (PWD). The intervention will be implemented by approximately 5 HPs specialized in dementia care based in the municipalities in Sweden. The main thrust of the intervention is to provide professional support, with help of an interactive mobile app, to family members in their caregiving role for PWDs. Qualitative interviews with HPs and FCs form the groundwork of the development of the mobile app. By using the app on smart phone or tablet, the FC, in groups of 8–10, will communicate with peers and a HP exchanging ideas on how to deal with PWD’s behavioral and cognitive changes and get support. They will also be able to discuss stressful events and access mindfulness exercises focused on themselves. Quantitative data will be collected before and at three time points after the 8-week intervention to assess changes in the health outcomes of the FCs. In-depth interviews will be conducted after the intervention to capture the experiences of FCs and HPs regarding the ease of use and acceptability of the app. Discussion This tailor-made mobile app has the high potential to

OBJECTIVE: The aim of this study was to explore the most distressing symptoms of systemic lupus erythematosus (SLE) and determine how these relate to health-related quality of life (HRQoL), anxiety/depression, patient demographics, and disease characteristics (duration, activity, organ damage). METHODS: In a cross-sectional study, patients with SLE (n = 324, age 18-84 years) gave written responses regarding which SLE-related symptoms they experienced as most difficult. Their responses were categorized. Within each category, patients reporting a specific symptom were compared with non-reporters and analysed for patient demographics, disease duration, and results from the following questionnaires: the Medical Outcomes Study 36-item Short Form Health Survey (SF-36), the Hospital Anxiety and Depression Scale (HADS), the Systemic Lupus Activity Measure (SLAM), the SLE Disease Activity Index (SLEDAI), and the Systemic Lupus International Collaboration Clinics/American College of Rheumatology (SLICC/ACR) damage index. RESULTS: Twenty-three symptom categories were identified. Fatigue (51%), pain (50%), and musculoskeletal distress (46%) were most frequently reported. Compared with non-reporters, only patients reporting fatigue showed a statistically significant impact on both mental and physical components of HRQoL. Patients with no present symptoms (10%) had higher HRQoL (p < 0.001) and lower levels of depression (p < 0.001), anxiety (p < 0.01), and disease activity (SLAM) (p < 0.001). CONCLUSION: Fatigue, pain, or musculoskeletal distress dominated the reported symptoms in approximately half of the patients. Only patients reporting fatigue scored lower on both mental and physical aspects of HRQoL. Our results emphasize the need for further support and interventions to ease the symptom load and improve HRQoL in patients with SLE. Our findings further indicate that this need is particularly urgent for patients with symptoms of pain or fatigue., Funding Agencies:King Gustaf V 80th Birthday Fund Åke Wiberg Foundation Alex and Eva Wallströms FoundationFoundation in memory of Clas Groschinsky

Background: Eczema is one of the most common diseases in the population, affecting individuals of all ages. The impact on physical and psychosocial wellbeing is important. This thesis describes some aspects of this complex of problems. The overall aim was to investigate the experience of living with eczema. Subjects: Adult individuals with self-reported eczema. Methods: In Study I, a questionnaire was sent to 1111 adult individuals, half of whom had school medical records from childhood that suggested atopic dermatitis, and an equal number of controls. The response rate was 70.5%. The first question 'Have you had childhood eczema?' was followed by questions about eczema later in life. Study II used a combination of methods. A questionnaire regarding care and treatment was sent to 75 patients with atopic dermatitis or psoriasis after a completed phototherapy treatment period. The response rate was 63%. Among the responders, 19 individuals who had volunteered were interviewed in gender specific groups or pairs. In Study III, a purposeful sample of 19 individuals was interviewed about their everyday experiences of eczema. In Study IV, 34707 individuals in Stockholm County Council responded to a public health questionnaire, which included a health related quality of life instrument, EQ-5D, and a validated question about hand eczema during the past year. Results: Of the 403 cases that were documented by a dermatologist in Study I, 29% did not report childhood eczema in the questionnaire. One of the differences between those who did and did not recollect their childhood atopic dermatitis concerned who had reported the diagnostic signs in childhood. Those who remembered their childhood eczema had more often had the condition reported by parents and school health personnel. Those who had forgotten had more often had their eczema reported only by parents or school health personnel. More in the remembering group also had eczema after the age of 15 years, or reported having ha

BACKGROUND: Psoriasis and atopic eczema are reportedly as common among women as among men and are not known to differ in severity between sexes. Research has shown that men get more treatment with ultraviolet (UV) light for longer periods than women. This fact, together with ongoing efforts to improve patient satisfaction with care and treatment at our department, prompted us to gather information from our patients. OBJECTIVE: The aim of this study was to explore patients' views of dermatological care and treatment methods. METHOD: A questionnaire-based survey was carried out, complemented with qualitative interviews. RESULTS: The main findings fall under three areas of clinical relevance: information to patients must be individually designed with a gender perspective; men and women have different attitudes towards greasing which must be kept in mind in clinical practice; and women often appear to be under-prescribed UV treatment. CONCLUSION: The information from our study can form a basis for new therapeutic strategies, taking a gender perspective into account.