To Örebro University

Well-being interventions are often designed and delivered based on external assumptions rather than students' perspectives, creating a research-practice gap that risks undermining their acceptability. This study explores students' perspectives on school-based mental health programs in general and on the new program Solution-focused Intervention for Mental health (SIM) in particular to explore its relevance and practical value for the students. Across three feasibility studies conducted over five years, we carried out 18 focus group interviews with students participating in SIM at four upper secondary schools in a medium-sized Swedish city. The material was analyzed using reflexive thematic analysis, which generated two main themes: Doing the right thing and Doing things right in school-based mental health interventions. The first theme reflects students' views that mental health and well-being are important topics in school and that programs should address both mental health problems and mental well-being. The second theme highlights the importance of age-appropriate formats and the need for safe dialogues about mental health. Overall, the study shows that adolescents value school-based mental health initiatives that promote mental well-being and address mental health problems, and that these initiatives are delivered in flexible, student-centered, and psychologically safe ways. These insights suggest that a dual-component approach to mental health may align better with adolescents' expectations, particularly in relation to mental health and well-being literacy. The results can inform the continued development and implementation of SIM and contribute to the design of more acceptable and relevant school-based interventions for adolescents.

People with cognitive disabilities are often excluded from research due to the inaccessibility of methods and assessment tools. Critical challenges include ensuring self-determination, developing inclusive recruitment methods, and enabling effective communication, all of which are essential to inclusive research. This article describes the use of graphic vignettes-illustrating various forms of violence-combined with semi-structured interviews as a multimodal approach to promote sensemaking and reflexivity related to violence against persons with cognitive disabilities. This methodological study is based on a reflexive thematic analysis conducted with 17 participants with cognitive disabilities (18 years or older). It describes the development of the vignettes and interview strategies designed to elicit participants' own understanding of violence while supporting their decision-making and sense of control over the interview process. The article also discusses the implications and value of using vignettes and interviews as a multimodal research approach that not only maximizes accessibility and flexibility but also enhances self-determination and actively builds trust; key aspects that support sense-making of sensitive topics, such as violence. In doing so, this study provides key methodological insights that uniquely facilitate reflection and the direct participation of this population in research about their lives.

Purpose: The purpose of this study is to identify what factors influence user satisfaction with vocational rehabilitation services among service users in a Swedish context.

Methods: In a randomized control trial, ordinal logistic regression was applied to a dataset of 631 completed questionnaires about the support provided in three different vocational rehabilitation programmes in Sweden—Supported Employment, Case Management and Regular Vocational Rehabilitation.

Results: The factors Person-centeredness, Trust in Support Persons, and Experience that the activities help with getting a job were significant factors of satisfaction among service users. The ordinal logistic regression model explained between 34.3% and 49.9% of the variance in the material, depending on the pseudo R2-measure used.

Conclusions: Service users who experience vocational support as person-centered, experienced trust in their support persons and that vocational rehabilitation activities help with getting a job are more satisfied with the vocational rehabilitation services than are other service users, independent of the vocational rehabilitation models used. Therefore, a person-centered approach is relevant to include in models’ development and service design of vocational rehabilitation.

Summary: Dialogues between professionals and clients in social work are central to identifying and providing support for violence in close relationships. How professionals approach dialogues about violence in close relationships with clients with cognitive disabilities, and associated challenges to making them accessible, are understudied. Semi-structured interviews with 18 professionals in disability services, domestic violence shelters, social services, and health services in Sweden were conducted. Previous findings and gaps in theory motivated an inductive content analysis which generated four categories that illustrate challenges to accessible violence in close relationship dialogues.

Findings: The four categories comprise challenges about : understanding and reasoning about violence; self-determination and protection; adapting assessment tools and approaches; and urgent and long-term approaches. These challenges entail difficulties in creating shared understandings and handling conflicting rights of clients. Furthermore, they included the need to adapt and maintain the validity of assessment tools, as well as organizational restrictions on the use of long-term approaches.

Applications: The findings shed light on how professionals must simultaneously handle various aspects of violence in close relationship dialogues. Verbally adhering to a given description of a situation was restricted by the need to maintain a professional-client relationship. When motivating the need to accept support, professionals had to avoid manipulating clients. Furthermore, the findings indicate several weaknesses in current practice that professionals struggle to address individually, such as, overly extensive assessment tools and little guidance on identifying less overt forms of violence in close relationships. Professional guidance is required in social work practice and related fields.

Background People with hearing loss (HL) report several challenging situations in working life (WL). HL can negatively affect, e.g., the ability to communicate, creating barriers and difficulties in WL. However, there is a lack of studies that investigates salutary aspects in relation to working conditions for the target group. Sense of Coherence (SOC) is a salutary concept widely used when investigating aspects in WL but is less explored in relation to HL.

Objective To explore the concept of Sense of Coherence (SOC) in relation to working conditions for employees with HL.

Methods An observational study with a cross-sectional design including people with HL in working age using hearing aids (HAs) or cochlear implants (CIs). Comparisons were made between participants "in work" and participants on "HL-related sick leave".

Results The "in work" group reported a higher SOC compared to the "HL-related sick leave" group. The analysis showed significant differences between the two groups in all three dimensions of SOC with the "in work" group being better off in almost all investigated variables.

Conclusion SOC is a valuable concept for investigating working conditions for employees with HL. The results indicate that to increase the possibility of salutary working conditions, it is necessary to focus on consequences of HL, such as the need for recovery, autonomy and support. Addressing these aspects increases employees' comprehension of and ability to manage the work situation and their sense of meaningfulness, which may act as a buffer against work-related stress and reduce the risk of sick leave.

PURPOSE: The aim of the current study was to translate the English original version of the Hearing and Functioning in Everyday Life Questionnaire (HFEQ) to Swedish, evaluate the translation in terms of comprehensibility and relevance from a patient perspective, and culturally adapt the Swedish version (HFEQ-SWE).

METHOD: A six-step methodology including translation into Swedish according to best practice methodology, evaluation, and cultural adaptation of the HFEQ-SWE using qualitative focus group interviews was used in this study. Thirteen adults with hearing loss were recruited from the audiological clinic in Örebro, Sweden. Their mean age was 57 years, and the four-frequency pure-tone average for the best ear ranged from 5 to 115 dB HL.

RESULTS: The results demonstrated that most of the items in the HFEQ-SWE were viewed as relevant by the informants. Not all items were considered relevant for all people, which also reflect the individual variability of everyday functioning. Most items were recognized as comprehensible without any changes needed.

CONCLUSIONS: Overall, the results indicate that the translation is semantically and culturally valid from the patient's perspective. Some revisions were suggested that need to be addressed in the further validation process of the HFEQ, and one item was removed.

Mental well-being is more than merely the absence of mental illness; it is a multidimensional concept that includes both emotional and functional well-being, which are valuable resources during adolescence. In order to develop relevant interventions and policies to strengthen adolescent mental health, a continuous monitoring of the population well-being becomes important. The aim of the study was to examine the level, distribution, and changes in mental well-being over time in a Swedish adolescent population. Current study is based on four waves (2014-2017-2020-2023) of a cross-sectional student survey (N = 16288, Mage = 16.23). The outcome was measured with the Mental Health Continuum Short Form. Ten explanatory factors were chosen to examine differences in mental well-being in the study population: Grade, Sex, Sexual orientation, Socioeconomic status, Country of birth, Visual, Hearing or Mobility impairment, Specific learning disorder and Neurodevelopmental disorder. Differences in mental well-being between groups as well as temporal trends were examined and evaluated through statistical testing and hierarchical multiple linear regressions modeling. Girls, non-heterosexual adolescents, and adolescents with low socioeconomic status or impairments have lower levels of mental well-being than boys, heterosexual adolescents, and adolescents with higher socioeconomic status or without impairments, respectively. A deterioration in mental well-being is seen over time for several groups; however, results of the multivariable analysis indicates that the deterioration is mainly an effect of sex and the significant decline in mental well-being seen among girls. The most significant factor for explaining the variation in mental well-being in this study is socioeconomic status. This study elucidates temporal changes and differences in levels of mental well-being between social groups in the adolescent population. The overall differences are small, but their potential implications for public health warrant careful consideration since they concern a significant part of the population. The results underscore the imperative of promoting mental well-being in adolescents, particularly among vulnerable groups.

A paucity of studies exists that report on the description and testing of school-based interventions set out to promote mental well-being among adolescents, particularly in a Swedish context. The aim of this paper is to describe a new strength-based intervention designed using the core elements of solution-focused brief therapy for coaching within a normative frame of mental well-being. The Solution-focused Intervention for Mental health (SIM) is a nine-week, classroom-based, group intervention that has been developed to be both feasible and effective in addressing the current public health challenge concerning adolescent mental health. The intervention is described in accordance with guidelines for group-based behaviour change interventions. The results of three subsequent studies are presented and they support the intervention's feasibility. These studies demonstrate improvements in student participation, session attendance and ratings, as well as in a mental well-being outcome. The first two studies show small effect sizes and the third shows a medium effect size, thereby further substantiating the efficacy of implementing SIM in upper secondary schools. The program is now ready to be evaluated in a forthcoming randomized controlled trial.

Case study research is an increasingly used research strategy in several academic disciplines, undertaken with the purpose of researching the phenomenon within a real-life context. A case study aims to analyse a spatially and temporally bounded case, to enable an in-depth understanding. Despite the growth of methodological literature, the concept of case study has been criticised for being fuzzy, and questions about the credibility of case study research have been raised. This chapter addresses issues of ontology, epistemology, and methodology that are central to the principles of case study design, with references to ongoing debates in the literature.

BACKGROUND: In Sweden, gender differences have been found in standard vocational rehabilitation as well as in evidenced-based methods such as Supported Employment (SE). However, these quantitative findings have not been followed up by qualitative research to clarify the issue.

OBJECTIVE: To explore participants’ experiences of participating in an SE intervention and the influence of gender on their experiences.

METHOD: Semistructured interviews with 10 women and 7 men participating in SE in Sweden were conducted. Qualitative content analysis followed by a gender analysis were performed using the material.

RESULTS: The participating men and women had different background characteristics. Overall, the participants shared the same experiences of SE. They valued a trustful relationship with the employment specialist and the diversified and individualized support from the employment specialist. Unlike the men, the women had experienced difficulties receiving SE from authorities, and when receiving SE, they expressed the value of a slow start, being challenged, and whole-life support.

CONCLUSION: The findings might moderate the rapid job principle in SE and indicate the need to acknowledge that the path to employment might look different, depending on the participants’ gendered experiences and living conditions, for SE to be more successful for both men and women.