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Conceptualizing healthcare professionals’ relational competence in mental healthcare: An integrative review
Get PDFIntroduction: The relationship between patients and mental health professionals is the cornerstone of all mental health treatment, and good patient-professional relationships are associated with several positive therapeutic outcomes for patients with mental health challenges. Mental health professionals’ relational competence is essential for high-quality services in mental healthcare. There is currently no unified understanding of the concept of relational competence. This study seeks to address this gap by exploring how relational competence is conceptualized within the context of mental healthcare. The research question was: How is relational competence described in the research literature within the context of mental healthcare?
Methods: An integrative review was conducted with systematic searches in the databases PsycInfo, Ovid Medline, Embase, CINAHL, ERIC, Academic Search Elite, IDUN, and Svemed+, spanning from January 2012 to October 2023, as well as hand searches in the reference lists of the included studies. A thematic synthesis was carried out based on the results in the included studies.
Results: Out of 2970 scientific studies screened, 30 were included, employing a variety of research methodologies to explore relational competence within mental healthcare. Four themes were found to describe relational competence in mental healthcare: having the ability to self-reflect and self-regulate, having a genuine interest in understanding the patient, engaging in reciprocal interaction with the patient, and meeting the patient so that they feel acknowledged. Each theme describes a central and important part of relational competence, but fully developed relational competence must be understood as a whole in which all the themes are present.
Conclusion: Relational competence in mental healthcare incorporates all the identified components. Each theme complements the others and contributes to the construction of a strong therapeutic relationship between patients and mental health professionals. To provide the best possible care for mentally ill patients, healthcare professionals must embrace and integrate these elements into their practice.publishedVersio
Urban-rural disparities in fatal and non-fatal paediatric injuries after trauma – A national retrospective cohort study
Get PDFIntroduction: Paediatric trauma is a leading cause of death, with correlations between trauma outcomes and geographical locations. Certain rural regions of Norway face a higher risk of trauma-related fatalities compared to the nationwide population. Among adults, the risk of both fatal and non-fatal injuries rises with increased rurality. The study aimed to investigate whether there is an increased risk of fatal and non-fatal injuries for children in rural areas across the entire country, as well as any changes over two decades.
Materials and methods: We conducted a retrospective cohort study of fatal and non-fatal paediatric injuries by accessing two national registries for all trauma-related patients under the age of 18. All cases were stratified into six groups according to level of centrality based on a national index used as a proxy for rurality. For inter-group comparison, urban-rural disparities were evaluated using Pearson`s Chi-square test, linear regression, and relative risk (RR).
Result: 1,059 paediatric deaths were included in the study period from 2002 to 2021. The mortality rate increased linearly with increased rurality (r = 0.985, p < .001). The overall mortality risk was 2.4 times higher in the most rural group compared to the most urban (RR = 2.37, 95 %CI 1.78 – 3.14, p < .001). Most deaths occurred pre-hospital (73 %), the total number of fatalities was highest in the age group 16 to 17 (42 %), and transport-related injury (32 %) was the most common cause of death. The relative risk of non-fatal injury was significantly higher for all centrality groups compared to most urban, and the highest rate was seen in sub-rural areas (RR = 1.39, 95 %CI 1.37 - 1.42, p < .001).
Conclusion: The mortality rate increased linearly across all levels of centrality, and the relative risk was 2.4 times higher in the most rural population compared to the most urban population. To effectively target primary prevention and enhance trauma care for paediatric patients in rural areas, a deeper epidemiological understanding and more comprehensive studies are essential.publishedVersio
Are social pressure, bullying and low social support associated with depressive symptoms, self-harm and self-directed violence among adolescents? A cross-sectional study using a structural equation modeling approach
Get PDFBackground: More in-depth evidence about the complex relationships between different risk factors and mental health among adolescents has been warranted. Thus, the aim of the study was to examine the direct and indirect effects of experiencing social pressure, bullying, and low social support on mental health problems in adolescence.
Methods: A school-based cross-sectional study was conducted in 2022 among 15 823 Norwegian adolescents, aged 13–19 years. Structural Equation Modelling was used to assess the relationships between socioeconomic status, social pressure, bullying, social support, depressive symptoms, self-harm and suicide thoughts.
Results: Poor family economy and low parental education were associated with high pressure, low parental support and depressive symptoms in males and females. Moreover, poor family economy was associated with bullying perpetration and bullying victimization among males and females, and cyberbullying victimization among females, but not males. Low parental education was associated with bullying victimization among males, but not females. Further, high social pressure was associated with depressive symptoms among males and females, whereas high social pressure was linked to self-harm and suicide thoughts among females, but not males. Bullying victimization and cyberbullying victimization were associated with depressive symptoms, self-harm, and suicide thoughts among males and females. Bullying victimization was associated with depressive symptoms among males, but not females, whereas bullying perpetration was linked to self-harm and suicide thoughts among females, but not males. Low parental support was associated with bullying perpetration, bullying victimization, depressive symptoms, self-harm and suicide thoughts among males and females, whereas low parental support was associated with high social pressure among females, but not males. Low teacher support was associated with high social pressure and depressive symptoms. Low support from friends was associated with bullying victimization, depressive symptoms and suicide thoughts among males and females, whereas low support from friends was linked to self-harm among males, but not females. Finally, results showed that depressive symptoms were associated with self-harm and suicide thoughts among males and females.
Conclusion: Low socioeconomic status, social pressure, bullying and low social support were directly and indirectly associated with depressive symptoms and self-directed violence among Norwegian adolescents.publishedVersio
Longing for humanity: The process of leaving a context of perceived spiritual abuse
Get PDFThis study provides an account of leaving a context of perceived spiritual abuse within some Pentecostal fellowships in Norway. We discuss how our 16 informants discovered the need for change and sought support to navigate challenging departure processes characterized by emotional strain. Three empirical themes emerged: (1) God’s will, as conveyed by leaders, evoked shame, (2) there were various sources of help in leaving a context of perceived spiritual abuse, and (3) the acknowledgment of vulnerability provided space for new images of God. Throughout the leaving process, many informants underwent a profound shift in their perceptions of God, marked by a heightened awareness of their vulnerability. This transformation encompassed a deep-seated desire to embrace their humanity and to accept the relevance of their thoughts and feelings. Acknowledging their own vulnerability allowed them to have more humanized images of God. Our analysis employs Kenneth Pargament’s notion of orienting systems and his theory of religious coping to elucidate how their images of God changed. The process led to a perceived sense of freedom from spiritual abuse. We understand the informants’ experiences of leaving the church and affiliated organizations as instances of deconversion through what empirically emerged as “deprogramming” processes in our material. Deprogramming involves disentangling individuals from what they perceived was conveyed and thus “programmed” by spiritual leaders. Deprogramming processes emerged as a new exploration of images of God, shame, power, and human vulnerability.publishedVersio
‘The state has a debt to us, it ended our dreams, our life project’: Reconstructing life projects after torture
Get PDFIntroduction: The concept of ‘life project’ is at the core of several decisions in the inter-American human rights system. The concept has also become part of the legal consciousness of torture survivors in Peru and is often referred to when they describe the impact of torture and imprisonment on their lives and on the lives of their children.
Methods: The paper is based on qualitative interviews with seven Peruvian torture survivors.
Results: The concept of ‘life project’ has been included in the legal consciousness of torture survivors in in Peru, and is used to address the ways in which torture and imprisonment has impacted not only on the life project of the person targeted, but also on the lives of their children. The interviewees describe damage to their life project both regarding health and the impact of stigma, but place special emphasis on the ways in which the life projects of their children have been impacted: as a result of being imprisoned, they have been unable to take care of their children for longer periods of time, their children have been subjected to violence, and they have had less access to education. Still, the interviewees describe how they reconstruct their life projects, as well as how the concept of life project serves as a starting point for demanding reparations.
Discussion: The concept of “life project”, originating from the inter American Court of Human Rights, is useful for grasping how peoples’ lives are impacted by imprisonment and torture, and has become part of the legal consciousness of persons affected by serious and systematic human rights violations in Peru.publishedVersio
Cultural correlates of personality: A global perspective with insights from 22 nations
Get PDFThe intersection of personality and culture has long intrigued various disciplines, having gained renewed attention with the advancements in psychometrics as a means to study personality traits as well as progression in the use of quantitative methods to study intercultural relations. This paper investigated the relationship between Hofstede’s cultural dimensions and the Big Five personality traits across 22 countries. It did so with the goal of testing hypotheses on whether Hofstede’s cultural dimensions significantly relate to the Big Five traits and whether countries sharing cultural similarities exhibit similar personality trait scores. The findings produced here highlight a substantial link between certain cultural dimensions (specifically, Masculinity, Power Distance, Individualism, and Uncertainty Avoidance) and the Big Five traits, while dimensions such as Long-Term Orientation and Indulgence did not significantly correlate with personality traits. Through regression and cluster analyses, this study confirmed that countries grouped based on cultural dimensions showed similar personality trait scores.publishedVersio
Social innovation as a pathway to social inclusion: The case of the Tumaini festival.
Get PDFThis thesis explores the role of the Tumaini Festival as a social innovation in the social inclusion of refugees in Malawi. It specifically focuses on the perspectives of the festival organizers, people who have attended the festival, and refugees and builds the study based on their experiences. Cultural events are recognized to have potential for the inclusion and integration of migrants. This study explores the potential this particular festival has in the social inclusion of refugees in Malawi, socially and economically, and whether it advocates for refugee rights. The study also sought to evaluate how the Tumaini festival impacts the refugees at Dzaleka refugee camp. To achieve these aims, the study used a qualitative method that employed key informants and in-depth interviews. It used social capital and cultural integration theories to understand and analyse the data collected. The study revealed that the Tumaini festival plays a potential role in the social inclusion of refugees by creating a platform where refugees and festival participants, both local and international, interact. These interactions lead to the construction of relationships, as well as understanding, empathy, and mutual respect between refugees and participants. Through the festival, refugees are financially empowered and seen beyond what the world portrays them. The festival at the refugee camp had both negative and positive impacts on the refugees, which are explored in the study
Identity and belonging among second-generation somalian migrants in Rogaland
Get PDFThe primary objective of the study was to find out the feeling of identity and sense of belonging that second-generation Somalians who live in Rogaland, Norway, experience. How do second-generation Somalians in Rogaland perceive their feeling of identity and belonging? is the key inquiry that leads the present study. Three significant municipalities in Rogaland County were deliberately selected as the areas to accomplish this. A total of eight in-depth interviews were carried out with second-generation Somali migrants, using a qualitative approach. The use of snowball sampling enabled it to be easier to attract four participants from the initial group of eight, whereas deliberate selection was utilized to purposefully select individuals in line with the project's objectives. Furthermore, all the study findings have been analyzed and presented applying a thematic approach.
The findings reveal that most of the interview participants from second-generation Somali migrants’ struggle with an identity during their formative years as they attempt to cope with their Somali heritage with their upbringing in Norway. For some, societal challenges push them towards identifying primarily as Somali, while others, facing fewer/no obstacles, comfortably embrace a dual cultural identity. The navigation and negotiation of dual cultural identity is a tricky step that depends on the individuals' sense of belonging and surroundings. Family plays a vital role with Somalian food, culture, and religion, in influencing their sense of identity. The Somali community, with its focal point often being the mosque, plays a crucial role in reinforcing Somali identity among youth in Rogaland. Despite being immersed in Norwegian society from birth, many incorporate Norwegian customs into their identity, often finding comfort in identifying as Somali later in life. This dual identity often entails adopting the best aspects of both cultures, though some Norwegian cultural practices may clash with religious beliefs, posing a barrier to full integration into Norwegian society
Fysiske omgivelser og teknologi i bofellesskap for unge voksne med nedsatt funksjonsevne. En studie av praksiser i spennet mellom mennesker og materialitet
Get PDFAll rights reserved. No part of this publication may be reproduced or transmitted, in any form or by any means, without permission.Bakgrunn: Over de siste tiårene har medborgerskap, levekår og muligheter for personer med nedsatt funksjonsevne fått stadig økende oppmerksomhet både nasjonalt og internasjonalt. Denne oppmerksomheten har blant annet ført til økt søkelys på konteksten og de omgivelsene som utgjør rammene for menneskers liv, samt de mulighetene og hindringene som kan ligge i samspillet mellom menneskene og deres omgivelser. På boligområdet er det en politisk målsetting at alle i Norge skal kunne bo trygt og leve gode liv i egen bolig så lenge som mulig. Dette gjelder også for personer med nedsatt funksjonsevne (Meld. St. 8 (2022-2023); Meld. St. 15 (2017-2018)). Samtidig pekes det på at personer med omfattende behov for tjenester har større vansker med å komme inn på boligmarkedet og færre muligheter for å velge hvor og hvordan de ønsker å bo (Kommunal- og moderniseringsdepartementet, 2020). Den materielle og teknologiske siden av å leve med funksjonsnedsettelse er i tillegg ennå lite utforsket (Buse et al., 2018; Bøhler & Giannoumis, 2018; Lee & Bartlett, 2021). Denne avhandlingen tar utgangspunkt i levekår i bofellesskap med kommunal døgnbemanning for unge voksne med moderat til alvorlig nedsatt funksjonsevne. Døgnbemannende bofellesskap er komplekse settinger der mange aktører er involvert og spiller inn både på hvordan livene leves, og hvordan tjenesteytingen foregår. Studien setter søkelyset på skjæringspunktet mellom menneskene og de fysiske omgivelsene, og utforsker hvordan fysisk utforming og teknologi inngår i, former og formes av aktiviteter og praksiser i bofellesskapene, samt hvilke verdier som blir til, og hvordan medborgerskap kan forstås i slike kontekster. I tillegg setter avhandlingen søkelys på selve forskningsprosessen, og på metodiske og forskningsetiske utfordringer i forbindelse med forskning i bofellesskap.
Metode: Studien har et etnografisk design med feltarbeid i tre bofellesskap i tre ulike kommuner i Norge. Dataetableringen foregikk primært ved bruk av feltarbeid med deltakende observasjon og samtaler med beboere og ansatte. Dette gav mulighet for å få frem praksiser og samspill mellom menneskene og omgivelsene i ulike aktiviteter – inklusiv praksiser som kan være vanskelige å få øye på og å sette ord på. I tillegg til deltakende observasjon ble det gjennomført individuelle intervjuer eller gruppe-intervjuer med enkelte beboere, pårørende og personale. Avhandlingens problemstilling besvares gjennom tre artikler tilknyttet hvert sitt forskningsspørsmål og en samlet presentasjon og diskusjon av resultater i denne kappen. Analysene tar utgangspunkt i kvalitativ innholdsanalyse. I to av artiklene benyttes teoretiske og analytiske begreper fra forskningsfeltet Science and Technology Studies (STS), samt Nicolinis (2009) metode med å «zoome inn og ut» på dataene.
Resultater: Med utgangspunkt i måltidsarrangementer utforsker den første artikkelen hvordan medborgerskap gjøres i og gjennom sosiomaterielle praksiser, og hvilken rolle de fysiske omgivelsene og teknologi har for de praksisene og verdiene som blir til. Artikkelen foreslår en inndeling av omgivelsene i tre ulike kategorier: storskala materialitet, som blant annet viser til bofellesskapenes utforming og teknologiske infrastruktur, småskala-teknologier, som blant annet inkluderer individuelle tekniske hjelpemidler, hvitevarer og mobiltelefoner, samt trivielle og hverdagslige objekter, som for eksempel ringpermer og kleshengere. Samlet får artikkelen frem hvordan den fysiske utformingen, teknologien og objektene i disse kategoriene på ulike måter legger premisser for hvilke aktiviteter som kan foregå, og hvordan, for hvilke praksiser som oppstår, og for hvilke verdier som realiseres gjennom praksisene. Artikkelen belyser hvordan medborgerskap kan forstås som gjort gjennom praksiser i sosiomaterielle relasjoner og derved må forstås i kontekst. Samtidig viser artikkelen at de verdiene som oppstår gjennom praksiser i ulike kontekster, ikke nødvendigvis sammenfaller med politiske føringer og målsettinger om medborgerskap.
I den andre artikkelen utforskes situasjoner med misforhold (misfit) mellom beboerne og de fysiske omgivelsene — det vil si situasjoner der relasjonen mellom beboere og elementer i de fysiske omgivelsene ikke fungerer eller hindrer ønsker aktivitet. Resultatene viser at slike situasjoner både kan oppstå akutt ved at tekniske hjelpemidler plutselig ikke fungerer, de kan ha en midlertidig karakter mens det søkes etter bedre langsiktige løsninger, eller det kan være misforhold knyttet til installerte fellesløsninger eller utformingen av bofellesskapene. Artikkelen eksemplifiserer hvordan misforhold oppstår, og får frem hvordan de involverte – spesielt de ansatte — kontinuerlig må vurdere muligheter og søke etter løsninger på slike situasjoner. Videre viser resultatene hvordan hverdagslige og tilsynelatende tilfeldige objekter har en viktig rolle i prosessen med å vurdere muligheter og håndtere misfit, samt til å skape flyt i hverdagen. Artikkelen fremhever derved betydningen av prosesser og objekter som det kan være vanskelig å få øye på i beboernes aktiviteter og i tjenesteytingen til personer med nedsatt funksjonsevne.
Den tredje artikkelen har søkelyset på metodiske og forskningsetiske valg og utfordringer i forskningsprosessen. Artikkelen eksemplifiserer og diskuterer utfordringer med å få tilgang til bofellesskap for personer som i forskningsetisk sammenheng vurderes som sårbare, samt utfordringer mellom forskningsetisk lovverk og -retningslinjer og behovet forsituasjonsbestemte vurderinger og skjønnsutøvelse i den praktiske gjennomføringen av feltarbeid, og omfatter også hvordan de fysiske omgivelsene inngår i forskerens valgmuligheter og vurderinger i praksis. Artikkelen får frem at forskningsetisk arbeid er omfangsrikt, og at forskeren ofte kan stå i situasjoner der det ikke er entydige retningslinjer for hvordan hun skal agere, eller hvor hun har begrenset informasjon til å kunne vurdere hensiktsmessig handling. Samtidig får artikkelen fram at forhandlinger er en viktig del av arbeidet, inklusive forhandlinger av egen rolle og av samtykker til deltakelse i studien. På den måten får artikkelen også frem hvordan samtykker i praksisnær forskning kan forstås som en prosess.
Diskusjon og konklusjon: Samlet bidrar avhandlingen til kunnskap om hvilken rolle fysiske omgivelser og teknologi har for beboernes aktiviteter, for tjenesteyting i bofellesskap og for hvilke verdier som blir til i den kompleksiteten av ulike behov, ønsker og muligheter som bofellesskapene representerer. Diskusjonen tar opp spenninger mellom ulike verdier og hensyn som synliggjøres gjennom studier av praksiser i skjæringspunktet mellom menneskene og omgivelsene, og diskuterer hvordan denne kunnskapen kan bidra til forståelsen av medborgerskap for beboerne. Avhandlingen konkluderer med at fysiske omgivelser og teknologi er viktige aktører i alle aktiviteter og situasjoner i bofellesskapene, og at deres ulike roller kan inndeles i ulike kategorier knyttet til både størrelse, omfang og muligheter for fleksibelt bruk. Mens bofellesskapenes utforming og innebygde teknologiske løsninger setter de overordnede rammene og mulighetsbetingelsene, er individuelle tekniske hjelpemidler og mellomstore objekter viktige for å støtte den enkeltes muligheter for aktivitet. Hverdagslige og tilsynelatende tilfeldige objekter er spesielt viktige i prosessen med å skape flyt i hverdagen og å håndtere situasjoner der relasjonen mellom beboere og elementer i de fysiske omgivelsene ikke fungerer. Disse objektene og prosessene kan derved både være avgjørende for å øke beboernes muligheter for aktivitet og deltakelse og for å fremme verdier knyttet til medborgerskap.
Avhandlingen bidrar samtidig til å sette søkelys på utfordringer mellom lovgivning og retningslinjer og behov for forskningsetisk skjønn i etableringen av empiriske data, og diskuterer om også gjennomføring av forskning i bofellesskap kan vurderes som medborgerskapspraksiser.
Paper I: Hoydal, K., & Thygesen, H. (2022). “Materiality and the enactment of citizenship in assisted living facilities for young adults.” I K. J. Fjetland, A. Gjermestad, & I. M. Lid (Red.), Lived citizenship for persons in vulnerable life situastions (162—179). Scandinavian University Press. https://doi.org/10.18261/9788215053790-2022-10
Paper II: Hoydal, K., & Thygesen, H. (2023). “The role of incidental objects in ‘making things work’: an example from assisted living facilities for young adults.” Scandinavian Journal of Disability Research, 25(1):350—362. DOI: https://doi.org/10.16993/sjdr.953
Paper III: Hoydal, K., Lid, I. M., & Thygesen, H. (2020). «Etikkarbeid i praksisnær forskning. Bofellesskap som forskningsarena». Fontene forskning, 13(1), 46—58. https://fontene.no/forskning/etikkarbeid-ipraksisnar-forskning-bofellesskap-som-forskningsarena-6.584.876653.156efbb122publishedVersio
Identity Negotiation of Ukrainian Refugees in Norway
Get PDFThis study employs Interpretive Phenomenological Analysis (IPA) to understand the lived experiences of Ukrainian refugees in Norway. The phenomenon of identity negotiation is investigated through semi-structured open-ended interviews. Four themes emerged: Going through a journey, Belonging, Different roles across countries and Participating in society. These themes address the main research question: “How do Ukrainian refugees negotiate their identity in Norway?” and the two sub-questions: “How do Ukrainian refugees view themselves?” and “How does the social group contribute to the identities of Ukrainian refugees?”. Findings reveal the complexities of identity negotiation among Ukrainian refugees in a new cultural context and the role of social groups in influencing identity