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  • 1.
    Arnberg, Filip K.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Bondjers, Kristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Panel discussion: early interventions after traumatic events2015In: European Journal of Psychotraumatology, ISSN 2000-8066, E-ISSN 2000-8066, Vol. 6, article id 28636Article in journal (Other academic)
  • 2.
    Cernvall, Martin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Psychology in Healthcare.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry.
    Bergh Johannesson, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Arnberg, Filip
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry.
    A pilot study of user satisfaction and perceived helpfulness of the Swedish version of the mobile app PTSD Coach2018In: European Journal of Psychotraumatology, ISSN 2000-8066, E-ISSN 2000-8066, Vol. 9, no Suppl 1, article id 1472990Article in journal (Refereed)
    Abstract [en]

    Background: There is a need for accessible interventions in the aftermath of traumatic events with documented efficacy for preventing or reducing negative mental health consequences. The PTSD Coach is a mobile app that has shown to be effective in reducing symptoms of posttraumatic stress (PTSS). Objective: The purpose of the current study was to evaluate the user satisfaction, perceived helpfulness and potential reductions of PTSS and symptoms of depression among participants using the Swedish version of the PTSD Coach. Method: This was an uncontrolled pre-test post-test open trial including participants recruited from the community via advertisement and from an ongoing observational study who had experienced a potentially traumatic event in the last five years. Participants had access to the Swedish PTSD Coach app for four weeks. Results: Eleven participants (mean age = 38.6, female = 8) completed the study. Nine of the participants met criteria for full or partial PTSD. Results from the PTSD Coach Survey indicated that participants found the app slightly to moderately helpful and were slightly to moderately satisfied with the app. Nominal but not statistically significant reductions of medium effect sizes in PTSS (PCL-5) and depression (PHQ-9) from pre- to post-assessment were found. In interviews, participants indicated that they found elements such as learning about PTSD, breathing exercises and monitoring symptoms helpful in managing symptoms. However, several participants indicated that they had not used the app as much as they had intended to. Participants also had suggestions for improvements such as enhanced app structure and better guidance regarding how to use the app. Conclusions: The perceived helpfulness and user satisfaction were slightly lower compared to research on the original version of the app. Experiences from the study are discussed and a future controlled study of the Swedish version of the PTSD Coach is suggested.

  • 3.
    Hensler, Ida
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Solid State Electronics. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ekselius: Psychiatry.
    Cernvall, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry.
    Arnberg, Filip
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry.
    PTSD Coach Sweden: A Self-Management App for Trauma-Related Symptoms: A RCT study protocol evaluating a self-help app for posttraumatic stress in a Swedish community sample2019In: European Journal of Psychotraumatology, ISSN 2000-8066, E-ISSN 2000-8066, Vol. 10, no S1, article id 4–010Article in journal (Other academic)
    Abstract [en]

    Background: Resources to administer evidence-based care for PTSD and trauma-related complications are scarce, especially in particular geographical areas, during mass casualty situations and for individuals with subclinical symptoms as clinics prioritize more severe cases. Effective interventions for PTSD through technical platforms could disseminate information and self-management strategies to decrease individual suffering and societal costs. Assessment at multiple time points can elucidate which aspects of an intervention that are effective, in addition to the evolution of intervention use and well-being over time. 

    Objective: Evaluate an app-administered self-help intervention (PTSD Coach Sweden) aiming to reduce and manage PTSD symptoms and other related complications. 

    Method: In this trial, 200 participants from Sweden who have experienced a traumatic event in the past two years and who report posttraumatic stress symptoms will be randomized to three months use of the app or waitlist. The primary endpoint is self-rated PTSD symptom severity at three months, with follow-up at six and nine months. Secondary outcomes include depressive symptoms, physical symptoms, functional impairment and health care use. Ecological momentary assessment of health status and use of strategies corresponding to app content is used for 21 days during the first three months.

    Results: Lessons learned and recommendations from the preparations of app-based intervention trials are presented. Available data from the primary endpoint are presented. 

    Conclusions: App-based interventions hold promise to increase outreach, but further trials are needed. Several challenges introduced when preparing an app-based intervention are discussed.

  • 4.
    Pohlkamp, Lilian
    et al.
    Ersta Skondal Bracke Univ Coll, Palliat Res Ctr, Dept Hlth Care Sci, Stockholm, Sweden.
    Kreicbergs, Ulrika
    Ersta Skondal Bracke Univ Coll, Palliat Res Ctr, Dept Hlth Care Sci, Stockholm, Sweden;Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.
    Prigerson, Holly G.
    Weill Cornell Med, Ctr Res End Life Care, New York, NY USA.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Ersta Skondal Bracke Univ Coll, Palliat Res Ctr, Dept Hlth Care Sci, Stockholm, Sweden.
    Psychometric properties of the Prolonged Grief Disorder-13 (PG-13) in bereaved Swedish parents2018In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 267, p. 560-565Article in journal (Refereed)
    Abstract [en]

    This study aimed to validate the Swedish version of the Prolonged Grief Disorder-13 tool (PG-13) by examining its psychometric properties, including factor structure, discriminant and concurrent validity. The PG-13 was assessed in a sample of Swedish parents who had lost a child to cancer 1-5 years previously. The sample included 225 parents (133 mothers and 92 fathers) with a mean age of 46.02 years (SD = 8.15) and 16.0% met the criteria for Prolonged Grief Disorder (PGD). A principal component analysis was performed, and the results supported a one-factor structure of the PG-13. The PG-13 was shown to have high internal consistency and intelligible associations with concurrent psychological symptoms and grief rumination as well as with known risk factors for PGD. These results indicate satisfactory psychometric properties of the instrument, thus supporting the use of the PG-13 as a valid measure of PGD.

  • 5.
    Pohlkamp, Lilian
    et al.
    Ersta Skondal Bracke Univ Coll, Palliat Res Ctr, Dept Hlth Care Sci, Stockholm, Sweden.
    Kreicbergs, Ulrika
    Ersta Skondal Bracke Univ Coll, Palliat Res Ctr, Dept Hlth Care Sci, Stockholm, Sweden;Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ekselius: Psychiatry. Ersta Skondal Bracke Univ Coll, Palliat Res Ctr, Dept Hlth Care Sci, Stockholm, Sweden.
    Bereaved mothers' and fathers' prolonged grief and psychological health 1 to 5 years after loss-A nationwide study2019In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 28, no 7, p. 1530-1536Article in journal (Refereed)
    Abstract [en]

    Objective To assess differences in prolonged grief, depression, posttraumatic stress, and sleep disturbances in bereaved parents across years since loss (1-5 years) and by gender and to assess potential interactive effects of time since loss and gender on bereavement outcomes. Methods This study examined symptom levels of prolonged grief disorder, depression, posttraumatic stress, and insomnia in bereaved parents. A sample, including 133 mothers and 92 fathers who had lost a child to cancer 1 to 5 years previously, subdivided to five subsamples, one for each year since loss. Analysis of variance (ANOVA) was used to assess differences in symptom levels, related to years since loss, and gender. Results Regardless of how many years had passed since the loss, symptom levels of prolonged grief, depression, posttraumatic stress symptoms, and insomnia were elevated in all subsamples. Mothers showed higher symptom levels of prolonged grief, depression, and posttraumatic stress than fathers. However, no significant interaction effects were found between years since loss and gender on any of the symptom levels. Conclusions Cancer-bereaved mothers and fathers are vulnerable to prolonged grief and psychological symptoms up to 5 years after the death of their child. Findings highlight that bereaved parents may need long-term support, and the results deserve further attention in research and clinical care.

  • 6.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Posttraumatic Stress and Cognitive Processes in Patients with Burns2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    A severe burn is one of the most traumatic injuries a person can experience. Posttraumatic stress disorder (PTSD) is relatively common after burns, and can be devastating for the individual’s possibilities for recovery. The principal aims were to gain knowledge regarding posttraumatic stress symptoms and cognitive processes after burn and to evaluate methods for assessing symptoms of PTSD up to one year after burn.

    The psychometric properties of a Swedish version of the Impact of Event Scale-Revised (IES-R) were examined. The results indicate that the IES-R is a valid screening instrument for measuring PTSD symptoms in patients with burns and it can be used during hospitalisation to identify resilient individuals.

    The pattern of PTSD symptoms over time was also investigated. Four distinct trajectories of PTSD symptoms were identified, i.e. four groups of patients with significantly different onsets and courses. The trajectories differed in the expected direction regarding several risk factors associated with PTSD symptoms.

    Several previously known risk factors for PTSD symptoms were also identified including burn severity, psychiatric history, previous life events, early psychological symptoms, neuroticism-related personality traits, avoidant coping and low social support. The risk factors correspond well with those reported in the international trauma literature, which strengthens the findings in this thesis.

    Finally, using the emotional Stroop task at one year post burn it was found that burn-specific attentional bias was common and associated with more previous life events, more perceived life threat, larger burns and higher levels of PTSD symptoms.

    In summary, there are individual differences in the development and course of PTSD symptoms after burn and attentional bias is a common cognitive phenomenon related to these symptoms. The findings also support the use of the IES-R as a screening instrument for PTSD symptoms in patients with burns.

     

    List of papers
    1. Psychometric properties of the impact of event scale-revised in patients one year after burn injury
    Open this publication in new window or tab >>Psychometric properties of the impact of event scale-revised in patients one year after burn injury
    Show others...
    2010 (English)In: Journal of Burn Care and Research, ISSN 1559-0488, Vol. 31, no 2, p. 310-318Article in journal (Refereed) Published
    Abstract [en]

    Burn injury can be a life-threatening and traumatic event. Despite considerable risk for psychological morbidity, few outcome measures have been evaluated. The aim of this study was to examine the psychometric properties of a Swedish version of the Impact of Event Scale-Revised (IES-R) in patients 1 year after burn injury (N = 147). A principal component analysis was performed, and the results supported the three-factor structure of the IES-R. High internal consistency and intelligible associations with concurrent psychological symptoms and known risk factors for distress after trauma indicate satisfactory psychometric properties. Thus, the study supports the use of the IES-R as a screening tool for measuring traumatic distress after burn.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-122812 (URN)10.1097/BCR.0b013e3181d0f523 (DOI)000275193400013 ()20182373 (PubMedID)
    Available from: 2010-04-20 Created: 2010-04-20 Last updated: 2017-01-25
    2. Validation of a Swedish version of the Impact of Event Scale-Revised (IES-R) in patients with burns
    Open this publication in new window or tab >>Validation of a Swedish version of the Impact of Event Scale-Revised (IES-R) in patients with burns
    Show others...
    2010 (English)In: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 24, no 6, p. 618-622Article in journal (Refereed) Published
    Abstract [en]

    The Impact of Event Scale (IES) and the Impact of Event Scale-Revised (IES-R) are often used as self-reportinstruments for symptoms of post-traumatic stress disorder (PTSD). However, there are few validationsof the IES and the IES-R against structured clinical interviews. In this study the two scales, together withthe three subscales of the IES-R, were assessed for their agreement with a diagnosis of PTSD in patientswith burns 1 year after injury. Sixty patients with burns were evaluated 1 year after injury using theStructured Clinical Interview for the DSM-IV Axis I (SCID-I) psychiatric disorders and a Swedish versionof the IES-R. The total score of the IES-R had the best discriminant ability (0.89) with a sensitivity of 1.0and a specificity of 0.78. In conclusion, the total IES-R had good properties as a screening tool for PTSDand subsyndromal PTSD 1 year after burn injury.

    Keywords
    Burns, IES-R, Physical trauma, Post-traumatic stress disorder, SCID, Validation
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-126277 (URN)10.1016/j.janxdis.2010.03.021 (DOI)000278476900011 ()20434306 (PubMedID)
    Available from: 2010-06-08 Created: 2010-06-08 Last updated: 2017-12-12Bibliographically approved
    3. A prospective longitudinal study of posttraumatic stress disorder symptom trajectories after burn injury
    Open this publication in new window or tab >>A prospective longitudinal study of posttraumatic stress disorder symptom trajectories after burn injury
    2011 (English)In: Journal of Trauma, ISSN 0022-5282, E-ISSN 1529-8809, Vol. 71, no 6, p. 1808-1815Article in journal (Refereed) Published
    Abstract [en]

    Background: Psychologic problems are common after burns, and symptoms of posttraumatic stress disorder (PTSD) are some of the most prevalent. Risk factors for PTSD have been identified, but little is known about the onset and course of these symptoms. The objective was to investigate whether there are different PTSD symptom trajectories after burns.

    Methods: Ninety-five adults with burns were enrolled in a prospective study from in-hospital treatment until 12 months after burn. Symptoms of PTSD were assessed with the Impact of Event Scale-Revised and scores at 3, 6, and 12 months after the burn were used in a cluster analysis to detect trajectories. The trajectories were compared regarding known risk factors for PTSD using non-parametric analysis of variance.

    Results: Four clusters were identified: (1) resilient, with low levels of PTSD symptoms that decreased over time; (2) recovery, with high levels of symptoms that gradually decreased; (3) delayed, with moderate symptoms that increased over time; and (4) chronic, with high levels of symptoms over time. The trajectories differed regarding several risk factors for PTSD including life events, premorbid psychiatric morbidity, personality traits, avoidant coping, in-hospital psychologic symptoms, and social support. The resilient trajectory consistently had fewer of the risk factors and differed the most from the chronic trajectory.

    Conclusions: There are subgroups among patients with burns that have different patterns of PTSD symptom development. These findings may have implications for clinical practice, such as the timing of assessment and the management of patients who present with these symptoms.

    Keywords
    Burns, cluster analysis, Post-traumatic stress disorder, Trauma, IES-R
    National Category
    Surgery Psychiatry
    Research subject
    Psychiatry
    Identifiers
    urn:nbn:se:uu:diva-142859 (URN)10.1097/TA.0b013e31822a30b8 (DOI)000298616400067 ()
    Available from: 2011-01-17 Created: 2011-01-17 Last updated: 2017-12-11Bibliographically approved
    4. Attentional bias and symptoms of posttraumatic stress disorder one year after burn injury
    Open this publication in new window or tab >>Attentional bias and symptoms of posttraumatic stress disorder one year after burn injury
    2009 (English)In: Journal of Nervous and Mental Disease, ISSN 0022-3018, E-ISSN 1539-736X, Vol. 197, no 11, p. 850-855Article in journal (Refereed) Published
    Abstract [en]

    Trauma-related attentional bias is suggested to play a role in maintaining posttraumatic stress disorder (PTSD). Although being burn injured is a traumatic event for many patients, there are no prospective studies investigating attentional bias. The aims were to assess burn-specific attentional bias 1 year after burn, and its associations with risk factors for PTSD and symptoms of PTSD. A total of 38 adult patients with burns were assessed with a structured clinical interview and a Swedish version of the Impact of Event Scale-Revised up to 1-year after burn. The Emotional Stroop Task was used to assess attentional bias 1 year after burn. In total 29 participants displayed burn-specific attentional bias. This group had more previous life events, perceived life threat, larger burns, and higher PTSD symptom severity. In conclusion, the majority of the patients had burn-specific attentional bias 1 year after burn and this was related to symptoms of PTSD.

    Keywords
    Impact of event scale-revised, physical trauma, posttraumatic stress disorder, selective attention, Stroop Task
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-122809 (URN)10.1097/NMD.0b013e3181bea555 (DOI)000272020900009 ()19996724 (PubMedID)
    Available from: 2010-04-20 Created: 2010-04-20 Last updated: 2017-12-12Bibliographically approved
  • 7.
    Sveen, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Andersson, Gerhard
    Linkoping Univ, Dept Behav Sci & Learning, Linkoping, Sweden.;Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Buhrman, Bo
    Linkoping Univ, Dept Behav Sci & Learning, Linkoping, Sweden..
    Sjöberg, Folke
    Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden..
    Willebrand, Mimmie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Internet-based information and support program for parents of children with burns: A randomized controlled trial2017In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 43, no 3, p. 583-591Article in journal (Refereed)
    Abstract [en]

    Background: The aim of the study was to evaluate the feasibility and effects of an intemet-based information and self-help program with therapist contact for parents of children and adolescents with burns. The program aimed to reduce parents' symptoms of general and posttraumatic stress.

    Methods: Participants were parents of children treated for burns between 2009-2013 at either of the two specialized Swedish Burn centers. Sixty-two parents were included in a two-armed, randomized controlled trial with a six-week intervention group and a wait list control group, including a pre and post-assessment, as well as a 3 and 12-month follow-up. The intervention contained psychoeducation, exercises and homework assignments, and the intervention group received weekly written feedback from a therapist. The main outcome was stress (post-traumatic stress, general stress and parental stress).

    Results: The program had a beneficial effect on posttraumatic stress in the short term, but did not affect general stress or parental stress. The parents rated the program as being informative and meaningful, but some of them thought it was time-consuming.

    Conclusion: The program has the potential to support parents of children with burns. The intervention is easily accessible, cost-effective and could be implemented in bum care rehabilitation.

  • 8.
    Sveen, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Andersson, Gerhard
    Institutionen för beteendevetenskap och lärande, Linköpings universitet.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sjöberg, Folke
    Institutionen för klinisk och experimentell medicin, Linköpings universitet.
    Buhrman, Bo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Willebrand, Mimmie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Internet-based information and self-help program for parents of children with burns: Study protocol for a randomized controlled trial2015In: Internet Interventions, ISSN 2214-7829, Vol. 2, no 4, p. 367-371Article in journal (Refereed)
    Abstract [en]

    Background

    A burn is one of the most traumatic and painful injuries a child can experience and it is also a very stressful experience for the parents. Given the great psychological distress and perceived lack of multi-professional support experienced by the parents, there is a need for support during in-hospital treatment as well as during recovery. The aim of the study is to develop and evaluate an internet-based information and self-help program for parents of children who have been hospitalized for burn injury. The program aims to decrease parents' symptoms of stress.

    Methods

    Participants will consist of parents of children treated for burns between 2009 and 2013 at either of the two specialized Swedish Burn centers. The study is a two-armed randomized controlled trial with a six-week intervention group and an inactive control group, with a pre- and post-assessment, as well as a 3- and 12-month follow-up. The main outcome is stress (post-traumatic stress, general perceived stress and parental stress). The data will be analyzed with the intention-to-treat principle. The intervention is based on Cognitive-Behavior Therapy (CBT) and is inspired by Acceptance and Commitment Therapy (ACT). It is psycho-educational and provides basic skills training in communication and stress management.

    Conclusion

    We believe that this program will offer parents of children with burns information and support, decrease symptoms of stress, and that parents will perceive the program as useful. If the program is found to be beneficial, it could be implemented in burn care as it is accessible and cost-effective.

  • 9.
    Sveen, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Ersta Skondal Univ Coll, Dept Hlth Care Sci, Palliat Res Ctr, Stockholm, Sweden..
    Arnberg, Filip
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden..
    Arinell, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Child and Adolescent Psychiatry.
    Johannesson, Kerstin Bergh
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry.
    The role of personality traits in trajectories of long-term posttraumatic stress and general distress six years after the tsunami in Southeast Asia2016In: Personality and Individual Differences, ISSN 0191-8869, E-ISSN 1873-3549, Vol. 97, p. 134-139Article in journal (Refereed)
    Abstract [en]

    The aims were to examine whether trajectories of posttraumatic stress (PTS) and general distress are related to personality traits and to investigate personality's contributing factor to PTS and general distress. The sample was 2549 Swedish tourists who survived the 2004 Indian Ocean tsunami and responded to postal surveys at 1, 3 and 6 years after the tsunami, including assessment of personality traits, PTS and general distress. The sample was categorized into a direct exposure group and an indirect exposure comparison group. For both PTS and general distress, individuals with a resilient trajectory were lower in the trait neuroticism than those in the symptomatic trajectories whereas there were no differences in personality traits between the resilient trajectory and the low exposure comparison group. Neuroticism was strongly related to trajectories of both PTS and general distress even when adjusting for important risk factors such as traumatic bereavement and exposure severity. Other personality traits demonstrated weak associations with the trajectories. The present findings correspond with the notion of neuroticism as a vulnerability factor for symptomatic long-term trajectories of posttraumatic and general distress whereas resiliency was not predicated by particularly low levels of neuroticism.

  • 10.
    Sveen, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Palliative Research Centre, Department of Health Care Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden .
    Bergh Johannesson, Kerstin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry.
    Cernvall, Martin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry.
    Arnberg, Filip
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Stress Research Institute, Stockholm University, Stockholm, Sweden .
    Trajectories of prolonged grief one to six years after a natural disaster2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 12, article id e0209757Article in journal (Refereed)
    Abstract [en]

    Background

    The long-term trajectories of prolonged grief are poorly understood. The aims were to examine the course of grief among bereaved disaster survivors up to six years post loss and factors predicting worse bereavement outcome. A third aim was to explore differences in grief indicators between trajectories.

    Methods

    Bereaved Swedish tourists who survived the 2004 Indian Ocean tsunamis responded to surveys including the Inventory of Complicated Grief 1 to 6 years after the disaster. Latent growth mixture modeling was used to identify longitudinal trajectories of grief. Multinomial logistic regression analysis was used to examine predictors of class membership.

    Results

    Three trajectories were identified: resilient (41% of the sample), recovering (48%), and chronic (11%). The strongest predictor of chronic grief was the loss of one’s child. When examining grief indicators, the chronic trajectory was characterized by not accepting the loss, while yearning was common in all trajectories.

    Conclusions

    This study highlights the importance of considering how traumatically bereaved individuals can be affected by loss for several years after a disaster, especially after losing one’s child. An inability to accept the loss, more so than yearning, appears to characterize bereaved survivors at risk of a chronic trajectory of grief.

  • 11.
    Sveen, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Bondjers, Kristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Willebrand, Mimmie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Psychometric properties of the PTSD Checklist for DSM-5: a pilot study2016In: European Journal of Psychotraumatology, ISSN 2000-8066, E-ISSN 2000-8066, Vol. 7, article id 30165Article in journal (Refereed)
    Abstract [en]

    Background: To date there is a lack of studies assessing the psychometric properties of the recently revised PTSD Checklist (PCL), the PTSD Checklist for DSM-5 (PCL-5). The aim of this pilot study was to examine the psychometric properties of the PCL-5 in parents of children with burns.

    Methods: The participating parents (N = 62, mean age = 38) completed self-report questionnaires, 0.8-5.6 years after their child's burn. Measures were the PCL-5, the Impact of Event Scale-Revised (IES-R), the Montgomery Asberg Depression Rating Scale (MADRS), and the Perceived Stress Scale (PSS). Burn severity of the child and sociodemographic variables was obtained.

    Results: The parents' average PCL-5 scores were low to moderate. The internal consistency of the PCL-5 was satisfactory, with Cronbach's alpha ranging from 0.56 to 0.77 and mean inter-item correlations ranging from 0.22 to 0.73 for the four PCL-5 subscales and the PCL-5 total. The PCL-5 subscales were moderately to highly correlated with the corresponding IES-R subscales as well as MADRS and PSS (p < 0.05), whereas associations with sociodemographics and burn severity were low to moderate.

    Conclusions: This study provides preliminary support for the use of PCL-5. The results indicate satisfactory psychometric properties of the PCL-5 as measured with internal consistency, test retest reliability, and aspects of convergent validity.

  • 12.
    Sveen, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Dyster-Aas, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Willebrand, Mimmie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Attentional bias and symptoms of posttraumatic stress disorder one year after burn injury2009In: Journal of Nervous and Mental Disease, ISSN 0022-3018, E-ISSN 1539-736X, Vol. 197, no 11, p. 850-855Article in journal (Refereed)
    Abstract [en]

    Trauma-related attentional bias is suggested to play a role in maintaining posttraumatic stress disorder (PTSD). Although being burn injured is a traumatic event for many patients, there are no prospective studies investigating attentional bias. The aims were to assess burn-specific attentional bias 1 year after burn, and its associations with risk factors for PTSD and symptoms of PTSD. A total of 38 adult patients with burns were assessed with a structured clinical interview and a Swedish version of the Impact of Event Scale-Revised up to 1-year after burn. The Emotional Stroop Task was used to assess attentional bias 1 year after burn. In total 29 participants displayed burn-specific attentional bias. This group had more previous life events, perceived life threat, larger burns, and higher PTSD symptom severity. In conclusion, the majority of the patients had burn-specific attentional bias 1 year after burn and this was related to symptoms of PTSD.

  • 13.
    Sveen, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Eilegard, Alexandra
    Steineck, Gunnar
    Kreicbergs, Ulrika
    They still grieve - a nationwide follow-up of young adults 2-9 years after losing a sibling to cancer2014In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 23, no 6, p. 658-664Article in journal (Refereed)
    Abstract [en]

    Objectives: The aims of this study were to assess the prevalence of unresolved grief in bereaved young adult siblings and examine possible contributing factors. Methods: The study was a Swedish population-based study of young adults who had lost a brother or sister to cancer, 2-9 years earlier. Of 240 eligible siblings, 174 (73%) completed a study-specific questionnaire. This study focused on whether the respondents had worked through their grief over the sibling's death and to what extent. Results: A majority (54%) of siblings stated that they had worked through their grief either not at all' or to some extent' at the time of investigation. In multiple regression analyses with unresolved grief as the dependent variable, 21% of the variance was explained by lack of social support and shorter time since loss. Conclusion: The majority of bereaved young adults had not worked through their grief over the sibling's death. A small group of siblings reported that they had not worked through their grief at all, which may be an indicator of prolonged grief. Lack of social support and more recent loss were associated with not having worked through the grief over the sibling's death.

  • 14.
    Sveen, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Gerdin, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Willebrand, Mimmie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    A prospective longitudinal study of posttraumatic stress disorder symptom trajectories after burn injury2011In: Journal of Trauma, ISSN 0022-5282, E-ISSN 1529-8809, Vol. 71, no 6, p. 1808-1815Article in journal (Refereed)
    Abstract [en]

    Background: Psychologic problems are common after burns, and symptoms of posttraumatic stress disorder (PTSD) are some of the most prevalent. Risk factors for PTSD have been identified, but little is known about the onset and course of these symptoms. The objective was to investigate whether there are different PTSD symptom trajectories after burns.

    Methods: Ninety-five adults with burns were enrolled in a prospective study from in-hospital treatment until 12 months after burn. Symptoms of PTSD were assessed with the Impact of Event Scale-Revised and scores at 3, 6, and 12 months after the burn were used in a cluster analysis to detect trajectories. The trajectories were compared regarding known risk factors for PTSD using non-parametric analysis of variance.

    Results: Four clusters were identified: (1) resilient, with low levels of PTSD symptoms that decreased over time; (2) recovery, with high levels of symptoms that gradually decreased; (3) delayed, with moderate symptoms that increased over time; and (4) chronic, with high levels of symptoms over time. The trajectories differed regarding several risk factors for PTSD including life events, premorbid psychiatric morbidity, personality traits, avoidant coping, in-hospital psychologic symptoms, and social support. The resilient trajectory consistently had fewer of the risk factors and differed the most from the chronic trajectory.

    Conclusions: There are subgroups among patients with burns that have different patterns of PTSD symptom development. These findings may have implications for clinical practice, such as the timing of assessment and the management of patients who present with these symptoms.

  • 15.
    Sveen, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Sjöberg, Folke
    Willebrand, Mimmie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Psychometric properties of the Swedish version of the burn outcomes questionnaire for children aged 5 to 18 years2012In: Journal of burn care & research: official publication of the American Burn Association, ISSN 1559-047X, Vol. 33, no 6, p. e286-e294Article in journal (Refereed)
    Abstract [en]

    Although pediatric burn injuries are common, there is a lack of burn-specific health outcome measurements for children. The American Burn Association and the Shriners Hospitals for Children have developed the Burn Outcomes Questionnaire (BOQ), which is a parent-report questionnaire measuring the functional outcome after burn in children aged 5 to 18 years. The aim of this study was to examine the psychometric properties of the Swedish version of the BOQ, assessing feasibility, reliability, and validity aspects. Participants were parents (n = 70) of children aged 5 to 18 years who were treated at the Uppsala or Linköping burn center between January 2000 and December 2008. For most subscales, feasibility was adequate and the internal consistency was good: Cronbach's α values were above 0.76 in all but 1 subscale, and mean interitem correlations ranged from 0.34 to 0.90. The test-retest reliability was significant in the majority of subscales. Evidence of validity was shown by associations among the BOQ subscales and between BOQ subscales and measures of burn severity, heat sensitivity, fear-avoidance beliefs, and parent reports of the child's psychological problems. In conclusion, with the exception of a few subscales, this study supports the continued evaluation of the Swedish version of BOQ as a tool to measure outcome after burn in children aged 5 to 18 years.

  • 16.
    Sveen, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Low, Aili
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Dyster-Aas, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Ekselius, Lisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Willebrand, Mimmie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Gerdin, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Validation of a Swedish version of the Impact of Event Scale-Revised (IES-R) in patients with burns2010In: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 24, no 6, p. 618-622Article in journal (Refereed)
    Abstract [en]

    The Impact of Event Scale (IES) and the Impact of Event Scale-Revised (IES-R) are often used as self-reportinstruments for symptoms of post-traumatic stress disorder (PTSD). However, there are few validationsof the IES and the IES-R against structured clinical interviews. In this study the two scales, together withthe three subscales of the IES-R, were assessed for their agreement with a diagnosis of PTSD in patientswith burns 1 year after injury. Sixty patients with burns were evaluated 1 year after injury using theStructured Clinical Interview for the DSM-IV Axis I (SCID-I) psychiatric disorders and a Swedish versionof the IES-R. The total score of the IES-R had the best discriminant ability (0.89) with a sensitivity of 1.0and a specificity of 0.78. In conclusion, the total IES-R had good properties as a screening tool for PTSDand subsyndromal PTSD 1 year after burn injury.

  • 17.
    Sveen, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Orwelius, Lotti
    Linköpings universitet.
    Gerdin, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Huss, Fredrik
    LInköpings universitet.
    Sjöberg, Folke
    Linköpings universitet.
    Willebrand, Mimmie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Psychometric properties of the impact of event scale-revised in patients one year after burn injury2010In: Journal of Burn Care and Research, ISSN 1559-0488, Vol. 31, no 2, p. 310-318Article in journal (Refereed)
    Abstract [en]

    Burn injury can be a life-threatening and traumatic event. Despite considerable risk for psychological morbidity, few outcome measures have been evaluated. The aim of this study was to examine the psychometric properties of a Swedish version of the Impact of Event Scale-Revised (IES-R) in patients 1 year after burn injury (N = 147). A principal component analysis was performed, and the results supported the three-factor structure of the IES-R. High internal consistency and intelligible associations with concurrent psychological symptoms and known risk factors for distress after trauma indicate satisfactory psychometric properties. Thus, the study supports the use of the IES-R as a screening tool for measuring traumatic distress after burn.

  • 18.
    Sveen, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, National Center for Disaster Psychiatry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Ersta Skondal Bracke Univ Coll, Dept Hlth Care Sci, Palliat Res Ctr, Stockholm, Sweden.
    Pohlkamp, Lilian
    Ersta Skondal Bracke Univ Coll, Dept Hlth Care Sci, Palliat Res Ctr, Stockholm, Sweden.
    Kreicbergs, Ulrike
    Ersta Skondal Bracke Univ Coll, Dept Hlth Care Sci, Palliat Res Ctr, Stockholm, Sweden;Karolinska Inst, Dept Womens & Childs Hlth, Stockholm, Sweden.
    Eisma, Maarten C.
    Univ Groningen, Dept Clin Psychol & Expt Psychopathol, Groningen, Netherlands.
    Rumination in bereaved parents: Psychometric evaluation of the Swedish version of the Utrecht Grief Rumination Scale (UGRS)2019In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 3Article in journal (Refereed)
    Abstract [en]

    Background

    Bereaved parents may be at higher risk to develop persistent, severe and disabling grief, termed prolonged grief. Grief rumination, repetitive thinking about the causes and consequences of the loss, is a malleable cognitive process that maintains prolonged grief. Grief rumination can be measured with the Utrecht Grief Rumination Scale (UGRS). The present study aimed to examine the psychometric properties of the new Swedish version of the UGRS in a sample of bereaved parents.

    Methods

    A Swedish nationwide postal survey including measures of demographic and loss-related variables, grief rumination (UGRS), and symptoms of prolonged grief, posttraumatic stress, anxiety, depression, and insomnia, was completed by 226 parents (133 mothers and 93 fathers) who lost a child to cancer in the past five years. Psychometric properties of the UGRS were examined through confirmatory factor analyses (CFA), reliability analyses, and assessment of UGRS score associations with symptoms of prolonged grief, posttraumatic stress, depression, anxiety, and insomnia.

    Results

    The internal consistency of the Swedish UGRS was good. The CFA yielded an acceptable fit for a two-factor hierarchical model with five sub-factors. Grief rumination was positively associated with all psychopathology symptom measures. Higher scores on UGRS were found in parents with possible prolonged grief disorder compared to those without (d=1.47). Moreover, the Swedish UGRS was associated with prolonged grief symptoms over and above loss-related and demographic variables and other psychopathology symptoms.

    Conclusions

    The Swedish UGRS demonstrated good psychometric properties, which supports its use as a measure to assess grief rumination in Swedish bereaved parents in research and practice.

  • 19.
    Sveen, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Ersta Skondal Univ Coll, Palliat Res Ctr, Stockholm, Sweden.
    Pohlkamp, Lilian
    Ersta Skondal Univ Coll, Palliat Res Ctr, Stockholm, Sweden.;Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
    Ohlen, Joakim
    Ersta Skondal Univ Coll, Palliat Res Ctr, Stockholm, Sweden.;Univ Gothenburg, Inst Hlth & Care Sci, Gothenburg, Sweden.;Univ Gothenburg, Ctr Person Ctr Care, Gothenburg, Sweden..
    Sandberg, Jonas
    Ersta Skondal Univ Coll, Palliat Res Ctr, Stockholm, Sweden.;Jonkoping Univ, Sch Hlth & Welf, Dept Nursing Sci, Jonkoping, Sweden..
    Brandange, Kristina
    Ersta Hosp, Dept Psychiat, Stockholm, Sweden..
    Gustavsson, Petter
    Karolinska Inst, Dept Clin Neurosci, Div Psychol, Stockholm, Sweden..
    Posttraumatic Stress among Not-Exposed Traumatically Bereaved Relatives after the MS Estonia Disaster2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 11, article id e0166441Article in journal (Refereed)
    Abstract [en]

    Background Little is known about posttraumatic stress (PTS) reactions in bereaved individuals following loss in disaster who were not directly exposed to disaster. The aim of the present study was to examine the course of PTS up to three years after losing relatives in the MS Estonia ferry disaster, one of the worst maritime disasters in modern times. Methods Seven postal surveys were sent out over three years post-disaster. The respondents were invited and added consecutively during the three years and 938 relatives participated in one or more of the surveys, representing 89% of the MS Estonia's Swedish victims. The survey included the Impact of Event Scale (IES) to measure PTS. Latent growth curve modeling was used to analyze PTS over time. Results The majority of bereaved individuals had high levels of PTS. At three years post-loss, 62% of the respondents scored above the recommended cut-off value on the IES. Over time, PTS symptoms declined, but initially high symptoms of PTS were associated with a slower recovery rate. Conclusion The present finding suggests that being an indirectly-exposed disaster-bereaved close-relative can lead to very high levels of PTS which are sustained for several years.

  • 20.
    Sveen, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sjöberg, F
    Öster, Caisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Health-related quality of life in Swedish pediatric burn patients and associations with burn and family characteristics2014In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 40, no 5, p. 987-994Article in journal (Refereed)
    Abstract [en]

    Although many children with burns recover well and have a satisfying quality of life after the burn, some children do not adjust as well. Health-related quality of life (HRQoL) focuses on the impact health status has on quality of life. The aim of this study was to assess HRQoL with the American Burn Association/Shriners Hospitals for Children Burn Outcomes Questionnaire (BOQ) in a nationwide Swedish sample of children with burns 0.3-9.0 years after injury. Participants were parents (n=109) of children aged up to 18 years at the time of investigation who were treated at the Linköping or Uppsala Burn Center between 2000 and 2008. The majority of children did not have limitations in physical function and they did not seem to experience much pain. However, there were indications of psychosocial problems. Parents of preschool children reported most problems with the children's behavior and family disruption, whereas parents of children aged 5-18 years reported most problems with appearance and emotional health. There were mainly burn-related variables associated with suboptimal HRQoL in children aged 5-18 years, while family-related variables did not contribute as much.

  • 21.
    Sveen, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sjöberg, F
    Öster, Caisa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Response to Letter to the Editor: 'Sleep quality implicates in life quality: an analysis about children who suffered burns'2014In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 40, no 4, p. 775-776Article in journal (Other academic)
  • 22.
    Sveen, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Willebrand, Mimmie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Feelings of guilt and embitterment in parents of children with burns and its associations with depression2018In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 44, no 5, p. 1135-1140Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim was to examine guilt and embitterment in mothers and fathers of children with burns and its associations with depression and burn severity. Methods: Parents (N=61, mothers n=41, fathers n=20) completed self-report questionnaires on guilt and embitterment, 0.8-5.6 years after their child's burn. Burn severity and sociodemographic variables were obtained from medical records and symptoms of depression were assessed with the Montgomery-Asberg Depression Rating Scale (MADRS). Results: The parents reported low levels of guilt, embitterment and depression. Burn-specific and general guilt were higher in mothers than fathers, but there were no differences in embitterment or symptoms of depression. General guilt was associated with depression, whereas burn-specific guilt and embitterment were not. Conclusions: Parents with general guilt may suffer from symptoms of depression. An implication is that clinicians should address guilt feelings among parents in order to alleviate distress and to identify any need for further counseling.

  • 23.
    Udo, Camilla
    et al.
    Dalarna Univ, Sch Educ Hlth & Social Studies, S-79188 Falun, Sweden;Ctr Clin Res Dalarna, CKF, Falun, Sweden;Ersta Skondal Bracke Univ Coll, Dept Hlth Care Sci, Palliat Res Ctr, Stockholm, Sweden.
    Lövgren, Malin
    Ersta Skondal Bracke Univ Coll, Dept Hlth Care Sci, Palliat Res Ctr, Stockholm, Sweden;Karolinska Inst, Dept Womens & Childrens Hlth, Paediat Oncol & Haematol, Stockholm, Sweden;Karolinska Univ Hosp, Astrid Lindgren Childrens Hosp, Childhood Canc Res Unit, Stockholm, Sweden.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Ersta Skondal Bracke Univ Coll, Dept Hlth Care Sci, Palliat Res Ctr, Stockholm, Sweden.
    Bylund-Grenklo, Tove
    Karolinska Inst, Dept Oncol Pathol Clin Canc Epidemiol, Stockholm, Sweden;Karolinska Inst, Dept Learning Informat Management & Eth, Learning Healthcare Contexts, Stockholm, Sweden.
    Alvariza, Anette
    Ersta Skondal Bracke Univ Coll, Dept Hlth Care Sci, Palliat Res Ctr, Stockholm, Sweden;Dalen Hosp, Capio Palliat Care, Stockholm, Sweden.
    Kreicbergs, Ulrika
    Ersta Skondal Bracke Univ Coll, Dept Hlth Care Sci, Palliat Res Ctr, Stockholm, Sweden;Karolinska Inst, Dept Womens & Childrens Hlth, Paediat Oncol & Haematol, Stockholm, Sweden.
    A Nationwide Study of Young Adults' Perspectives on Participation in Bereavement Research2019In: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740Article in journal (Refereed)
    Abstract [en]

    Background: Young adults represent a minority in research; they are often considered too young or too old for participation. There is sparse information, especially in bereavement research, regarding how this age group perceives research participation and what they consider beneficial or harmful.

    Aim: To explore how parentally bereaved and nonbereaved young adults perceive research participation.

    Design: Qualitative analysis of free-text comments collected in a Swedish nation-wide survey.

    Setting/Participants: Parentally cancer-bereaved and nonbereaved young adults between 18 and 25 years old living in Sweden.

    Results: Five categories were identified from the free-text comments, three among the cancer-bereaved: (1) therapeutic to remember the deceased, (2) valuable to help others and improve care, and (3) short-term distressful-long-term beneficial, and two among the nonbereaved: (1) increased reflection and awareness about life, and (2) an opportunity to help others.

    Conclusions: It is important to invite young adults to participate in bereavement research. The results suggest that potential harm is minimal and that participating in bereavement research can have a beneficial effect on young adults.

  • 24.
    Weber, Megan
    et al.
    Ersta Skondal Bracke Univ Coll, Dept Caring Sci, Palliat Res Ctr, Stockholm, Sweden.
    Alvariza, Anette
    Ersta Skondal Bracke Univ Coll, Dept Caring Sci, Palliat Res Ctr, Stockholm, Sweden;Dalen Hosp, Capio Palliat Care, Stockholm, Sweden.
    Kreicbergs, Ulrika
    Ersta Skondal Bracke Univ Coll, Dept Caring Sci, Palliat Res Ctr, Stockholm, Sweden;Karolinska Inst, Dept Women & Childs Hlth, Stockholm, Sweden.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Ersta Skondal Bracke Univ Coll, Dept Caring Sci, Palliat Res Ctr, Stockholm, Sweden.
    Communication in families with minor children following the loss of a parent to cancer2019In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 39, p. 41-46Article in journal (Refereed)
    Abstract [en]

    Purpose:

    Family communication is a known protective factor for minor children's psychological health following the death of a parent, but there is little research describing communication within such families specifically from the perspective of the children. The purpose of this study was therefore to explore communication in parentally bereaved families from the perspective of the children and surviving parent.

    Methods:

    Interviews with four parents and four children from four families were analyzed using inductive content analysis. Interviews took place in the family's home or at the research center based on the family's wishes 4-14 months after a parent had died. Interviews had an open approach and were based on an interview guide. Each interview was between 60 and 120 min long.

    Results:

    Four categories emerged which were related to family members' experiences of family communication while adjusting to their new circumstances as bereaved: the importance of open and honest communication in the family; new challenges in the family which affect communication; communicating the need for help; and talking about and remembering the deceased parent.

    Conclusions:

    This study illuminates the connection between family communication and adjustments to new circumstances following the death of a parent. The results suggest that the relationship between family adjustment and communication may be circular whereby the family's ability to adjust to their new circumstances is affected by how the family communicates. Similarly, family communication may be affected by the family's coping strategies and ability to adjust to their new circumstances.

  • 25.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Uppsala Univ Hosp, Burn Ctr, Dept Plast & Maxillofacial Surg, S-75185 Uppsala, Sweden.
    Sjöberg, Folke
    Linkoping Univ, Dept Clin & Expt Med, S-58183 Linkoping, Sweden.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery. Uppsala Univ Hosp, Burn Ctr, Dept Plast & Maxillofacial Surg, S-75185 Uppsala, Sweden.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Parents' perceived quality of pediatric burn care.2018In: Journal of critical care, ISSN 0883-9441, E-ISSN 1557-8615, Vol. 43, p. 256-259Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To describe parents' perceived quality of pediatric burn care and evaluate factors associated with differences in perceived quality among parents.

    METHODS: 62 parents of children with burns were recruited on a Swedish national basis 0.8 to 5.6years after the child's injury. Measures were an adaptation of the Quality of Care Indices - Parent questionnaire consisting of 8 subscales and one overall question, the Impact of Event Scale -Revised, Montgomery Åsberg Depression Rating Scale, and Injury-specific fear-avoidance.

    RESULTS: Ratings of quality of care were high, especially regarding Staff Attitudes, Medical Treatment, and Caring Processes. Overall satisfaction rated from 1 to 10 was on average 9.1 (SD=1.2). Overall satisfaction and specific indices of Quality of care were not associated with burn severity, parent gender, or parent age. However, Quality of care was associated with current symptoms of posttraumatic stress and depression, and parents of girls expressed being less satisfied with Participation.

    CONCLUSIONS: Parents' perceived quality of care is associated with psychological health, but not with characteristics of the child's injury or age. The results suggest that burn care can improve by involving parents of girls more and by being more attentive towards parents who themselves appear stressed or worried.

  • 26.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Injury-related fear-avoidance and symptoms of posttraumatic stress in parents of children with burns2016In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 42, no 2, p. 414-420Article in journal (Refereed)
    Abstract [en]

    Parents of children with burns experience a range of psychological reactions and symptoms, and parents’ health is known to impact children's health. So far, there is little research into potential mechanisms that maintain parents’ symptoms. The aim was to investigate parental injury-related fear-avoidance, and its associations with injury severity and health measures. Parents (n = 107) of children aged 0.4–18 years that sustained burns 0.1–9.0 years previously completed questionnaires on fear-avoidance, posttraumatic stress, and health of the child. Analyses showed that the average level of fear-avoidance was low and positively associated with measures of injury severity and parents’ symptoms of posttraumatic stress, and negatively associated with parents’ ratings of their child's health. In two separate multiple regressions with parents’ symptoms of PTSD and the child's health as dependent variables, fear-avoidance made the largest contribution in both models while injury severity was non-significant. Results were not related to comorbid conditions of the child, scarring, or parent-related socio-demographic variables. In summary, injury-related fear-avoidance is more likely among parents whose children sustain more severe burns. In turn, fear-avoidance contributes significantly to parents’ symptoms of PTSD and to poorer health ratings regarding the child, irrespective of injury severity or child comorbidity.

  • 27.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Perceived support in parents of children with burns2016In: General Hospital Psychiatry, ISSN 0163-8343, E-ISSN 1873-7714, Vol. 38, no 1, p. 105-108Article in journal (Refereed)
    Abstract [en]

    Objective

    Children sustaining burns that require treatment in a burn center have a need for multiprofessional aftercare services over a prolonged time. So far, there is little research into satisfaction with care and support after pediatric burns. The aim was to investigate parents’ perception of support after pediatric burn and associations with parent, child and injury characteristics.

    Method

    Parents (n= 101) of children aged 0.4–17.8 years completed questionnaires on support, parent’s psychological symptoms and health of the child. Time since injury was 0.1–9.0 years.

    Results

    Perceived lack of psychosocial, medical, societal or family support was reported by 21% of the parents. Lack of support was not associated with injury or sociodemographic characteristics, but it was significantly associated with parents’ symptoms of general anxiety, depression and injury-related fear avoidance, as well as parents’ ratings of their child’s general health and heat sensitivity.

    Conclusion

    Perceived support did not differ on account of burn severity or sociodemographic status. However, care providers should be more attentive to and supportive of parents signaling poorer general health in their child and cognitive beliefs that the child is at risk for harm when active and parents who themselves show signs of psychological symptoms.

  • 28.
    Willebrand, Mimmie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Ramklint, Mia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Bergquist, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
    Huss, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Sjöberg, Folke
    Psychological problems in children with burns: Parents' reports on the Strengths and Difficulties Questionnaire2011In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 37, no 8, p. 1309-1316Article in journal (Refereed)
    Abstract [en]

    Burns may have a devastating effect on psychological health among children, although previous studies report difficulties as well as positive findings. The aims were to describe the rate of psychological problems in children with burns using a standardised instrument and to explore statistical predictors of these problems. Parents (n = 94) of children aged 3-18 years who sustained burns 0.3-9.0 years previously answered the Strengths and Difficulties Questionnaire (SDQ) covering Emotional symptoms, Conduct problems, Hyperactivity/Inattention, Peer relationship problems, Prosocial behaviour, and a Total difficulties score. Questions regarding parental psychological health and family situation were also included. The results for three of the SDQ subscales were close to the norm (10%) regarding the rate of cases where clinical problems were indicated, while the rate of cases indicated for Conduct, Peer problems and Total difficulties was 18-20%. Statistical predictors of the SDQ subscales were mainly parents' psychological symptoms, father's education, and changes in living arrangements. Visible scars were relevant for the Total difficulties score and Hyperactivity/Inattention. In summary, a slightly larger proportion of children with burns had psychological problems than is the case among children in general, and family variables exerted the most influence on parental reports of children's psychological problems.

  • 29.
    Öster, Caisa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Is sexuality a problem?: A follow-up of patients with severe burns 6 months to 7 years after injury2015In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 41, no 7, p. 1572-1578Article in journal (Refereed)
    Abstract [en]

    PURPOSE AND AIMS:

    This is the first study investigating sexuality from 6 months up to 7 years after burn. The aim was to examine sexuality in females and males by using the BSHS-B sexuality subscale and to examine possible contributing factors with regard to sociodemographics, burn characteristics, personality traits, and previous psychiatric disorders.

    METHODS:

    A cohort of 107 patients consecutively admitted to a Swedish national burn center was followed up at 6, 12, and 24 months after burn, and 67 individuals were followed up at 2-7 years after burn. The present study utilized the BSHS-B sexuality subscale, and multiple regression analyses were used to examine possible contributing factors.

    RESULTS:

    Women were less satisfied than men, and sexuality mean scores improved over time, even up to 7 years after-burn, in both men and women. The strongest contributing factors for worse outcome regarding sexuality were a history of psychiatric morbidity, neuroticism and burn severity.

    CONCLUSIONS:

    As some patients experience sexual problems after burns, even many years later, it is important to identify these individuals. The BSHS-B sexuality subscale may be used as a screening tool, but more in-depth assessment might be needed to address all aspects of sexuality.

  • 30.
    Öster, Caisa
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sveen, Josefin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    The psychiatric sequelae of burn injury2014In: General Hospital Psychiatry, ISSN 0163-8343, E-ISSN 1873-7714, Vol. 36, no 5, p. 516-522Article in journal (Refereed)
    Abstract [en]

    Objective: To examine factors predicting psychiatric morbidity, taking into account the full range of psychiatric disorders before and after burn injury. Methods: A cohort of 107 patients consecutively admitted to a Swedish national burn center was examined for lifetime psychiatric morbidity, as well as 94 patients at 1 year postinjury. Sixty-seven individuals, some from that same cohort, were interviewed at 2 to 7 years postinjury. The predictive effects of psychiatric history, personality and other risk factors for psychiatric morbidity following burn were evaluated with multiple regression analyses. Results: The prevalence of having a psychiatric disorder preburn was 57%. One year postinjury 19% had minor or major depression and 23% had subsyndromal or full posttraumatic stress disorder. At 2 to 7 years, 31% fulfilled the criteria for a psychiatric disorder. The strongest contributing factors were a history of psychiatric morbidity and neuroticism. Conclusions: Two-thirds of the patients had a lifetime psychiatric disorder, and one-third had a psychiatric diagnosis 2 to 7 years postburn. Mental health problems can have a major impact on daily life and functional abilities. Thus, identification and treatment of a range of psychiatric disorders, taking into account preburn psychiatric disorders and personality, is important for optimal adjustment after burn.

1 - 30 of 30
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