Swedish mental health-care services are experiencing a critical shortage of nursing personnel. Researchers suggest that this shortage is due to low levels of job satisfaction. Job satisfaction is frequently studied with the assistance of Herzberg's two-factor theory, and this theory has foremost been explored with studies using quantitative methods. The purpose of the present study was to provide a better understanding of Herzberg's theory in relation to job satisfaction among Swedish mental health nursing personnel within inpatient psychiatric care while using qualitative methodology. This explorative study was based on semistructured interviews with 25 nursing personnel. Qualitative content analysis of interview transcripts identified three main categories: (i) respondents' perception of their work duties, which was perceived as important, meaningful, and demanding; (ii) respondents' relations with colleagues and supervisors, which provided valuable support in everyday work; and (iii) the way the respondents experienced their professional role as mental health nurses, which was described as unclear and vague. Job satisfaction primarily stemmed from working for patients and with other professionals, but their perceived limited progression of responsibilities discouraged a career in the profession. Herzberg's theory proved useful in exploring job satisfaction in this setting, but the findings partly contradict the basic tenets of the theory. Career advancements and incentives, such as salary and compensation, were perceived as lacking, which negatively influenced job satisfaction. Ward managers should establish clinical ladder programmes to recognize and motivate the continuing professional development of nurses. This needs to be coupled with monetary incentives, and linked with increased clinical authority.
This study aimed to explore experiences with online information regarding food, weight management, and health in a group of adolescents in treatment for obesity. Individual semi-structured interviews with 20 adolescents were conducted. Participants used a screen-recorded laptop to demonstrate their search procedures and online information sources. The transcribed interviews were categorized using qualitative content analysis. The adolescents described both encouraging and discouraging experiences. On one hand, they said that online forums could provide nutritious meal ideas and inspiration as well as social support for behavior change. On the other hand, they mentioned that there was a confusing amount of misleading commercial content online and also experiences of peer-facilitated food marketing in online networks. An overarching theme was generated: social media might be a resource for health inspiration, health information, and social support, but requires awareness and competencies. Implications for clinical practice are discussed in light of these findings.
Background
The World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2.0) is a self-administered instrument to assess functional impairment. It is used in the general population as well as different patient groups. However, its application to patients with psychotic disorders may be hampered by disease-specific difficulties of self-estimation. This study aimed to examine the psychometric properties of the short (12-item) WHODAS-2.0 in a naturalistic sample of outpatients attending a psychosis clinic in Gothenburg, Sweden.
Methods
Annual data from two outpatient clinics registered 2016–2019 were analyzed retrospectively. The assessment of the short WHODAS-2.0 was based on the first questionnaire completed by 881 patients. Confirmatory factor analysis evaluated previously validated models. Item convergent and discriminant validity as well as internal reliability were computed. Construct validity was assessed by comparing mean differences in accord with previous research regarding patients’ characteristics associated with functioning such as advanced age, diagnosed comorbidities, antipsychotic treatment status, and symptom severity measured with PANSS-8 remission items.
Results
A heterogeneous sample was obtained in terms of age (range: 20–92), various living situations, and different geographic areas of birth. Most patients (75%) had been diagnosed with psychotic disorders more than 10 years ago and the majority (89%) were on antipsychotic medication. We confirmed an adjusted two-level factor model with a single second-order disability factor and six first-order factors representing the six IFC dimensions. The WHODAS-2.0 sum score measuring general disability showed good reliability (Cronbach's alpha = 0.89). Construct validity was confirmed as older patients, patients with comorbidities, and patients in assisted living had higher WHODAS-2.0 scores. Patients with no or mild psychotic symptoms had significantly lower WHODAS-2.0 sum scores than patients with more severe symptoms.
Conclusions
The findings further validate the 12-item WHODAS-2.0 in a naturalistic sample of outpatients with psychotic disorders. This study corroborates the clinical significance of the short, 12-item WHODAS-2.0 by demonstrating consistent associations between patients’ age, medical comorbidities, living situation, antipsychotic treatment status, and psychotic symptom severity.
BackgroundEmerging research suggests that social media has the potential in clinical settings to enhance interaction with and between pediatric patients with various conditions. However, appearance norms and weight stigmatization can make adolescents with obesity uncomfortable about using these visual-based media. It is therefore important to explore these adolescents’ perspectives to identify the implications and concerns regarding the use of social media in clinical settings.ObjectiveTo explore the experiences of adolescents in treatment for obesity in terms of how they present themselves on social media, their rationale behind their presentations, and their feelings related to self-presentation.MethodsInterviews were conducted with 20 adolescents enrolled in a pediatric outpatient obesity clinic, then transcribed and categorized using qualitative content analysis and Goffman’s dramaturgical model. Participants used a screen-recorded laptop to demonstrate their online self-presentation practices.Findings: Adolescent girls and boys undergoing treatment for obesity used visual-based social media, but girls in particular experienced weight stigma online and undertook self-presentation strategies to conceal weight-related content such as avoiding showing close-up photos of their bodies and not posting images of unhealthy “fattening” foods. Participants perceived the potential use of social media in clinical settings as being too risky and private.ConclusionsGiven the complexity of general visual-based social media use by adolescents, and not wanting their patient status to be visible to peers, healthcare should primarily focus on working with more restricted instant messaging when engaging with adolescents with obesity.
Purpose:This study aimed to describe adolescents’ experiences of participating in a health-promoting school-based intervention regarding food and physical activity, with a focus on empowering aspects. Method: The school was located in a urban disadvantaged community in Sweden, characterized by poorer self-reported health and lower life expectancy than the municipality average. Focus group interviews with adolescents (29 girls, 20 boys, 14–15 years) and their teachers (n = 4) were conducted two years after intervention. Data were categorized using qualitative content analysis. Results: A theme was generated, intersecting with all the categories: Gaining control over one’s health: deciding, trying, and practicing together, in new ways, using reflective tools. The adolescents appreciated influencing the components of the intervention and collaborating with peers in active learning activities such as practicing sports and preparing meals. They also reported acquiring new health information, that trying new activities was inspiring, and the use of pedometers and photo-food diaries helped them reflect on their health behaviours. The adolescents’ experiences were also echoed by their teachers. Conclusions: To facilitate empowerment and stimulate learning, health-promotion interventions targeting adolescents could enable active learning activities in groups, by using visualizing tools to facilitate self-reflection, and allowing adolescents to influence intervention activities.
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