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Background

Obesity and Type 2 diabetes (T2D) impair health-related quality of life (HRQoL) across metabolic, mechanical and mental domains. Gastric bypass surgery improves HRQoL in the short term, but long-term trajectories remain insufficiently understood. This study evaluated HRQoL 8 years after gastric bypass in a cohort with T2D, integrating quantitative assessments with qualitative exploration of lived experiences.

Methods

Eleven individuals with obesity and T2D who underwent gastric bypass participated in an 8-year follow-up. Anthropometric and clinical data were collected. HRQoL was assessed using the RAND SF-36, and changes over time were analyzed using repeated-measures ANOVA. Correlations between changes in BMI, HbA1c and HRQoL domains were assessed with Spearman correlations. Semi-structured qualitative interviews were conducted, transcribed verbatim and analyzed using reflexive thematic analysis.

Results

Participants experienced modest weight regain but significant deterioration in glucose control from the 2-year to the 8-year follow-up. RAND SF-36 scores returned to preoperative levels, and the mental health score was significantly reduced compared to the 2-year follow-up (q < 0.01). Weight regain correlated with reduced physical functioning, role-physical and vitality scores (all r < −0.7, p < 0.05), while HbA1c increase correlated with poorer mental health and role-emotional scores (all r < −0.6, p < 0.05). Qualitative interviews revealed that long-term HRQoL was dynamic and shaped by an interplay of physical functioning, psychological wellbeing, body adaptations, social support and life events. An overarching theme emerged: Quality of life after gastric bypass is a multidimensional, evolving process influenced by changing health, life circumstances and psychosocial factors over time.

Conclusions

Initial postoperative improvements in HRQoL were not sustained at 8 years and might have been influenced by weight regain, T2D relapse and intercurrent illness. However, lived experiences highlighted meaningful and durable benefits in physical functioning and self-perception for several participants. The findings underscore the need for long-term, holistic follow-up that integrates metabolic monitoring with psychological and social support.

Trial Registration

ClinicalTrials.gov registration: NCT02729246

Parenting Young Children is a home-based parenting support program for parents with intellectual and developmental disabilities. The program focuses on parents' ability to care for and interact with their children and is adjusted to each parent's needs through individualised goal-setting. The program has been implemented in many Swedish municipalities, and practitioners perceive it as useful, but there is scarce knowledge about parents' perspectives. The aim of the present study was therefore to examine parents' experiences of the impact of the Parenting Young Children program on their parenting skills and parenting role. Semi-structured individual interviews were held with 15 parents (eight mothers) who had intellectual and developmental disabilities and were assessed as needing parental support due to concerns about neglect. The parents received the program from social services, delivered through weekly sessions for at least 6 months. Data were analysed using reflexive thematic analysis. Parents perceived that the program had a positive impact on their parenting knowledge and skills. They described learning about their children's developmental needs and improving their understanding of their children. They also expressed that they acquired new skills, increased their responsiveness and interaction skills, and improved their parent-child relationships. Parents further described becoming more confident over time and growing into their roles, and that the program had a significant impact on family life, encouraging shared parental responsibility. The findings indicate that parents with intellectual and developmental disabilities perceive the program as helpful for developing knowledge, skills and confidence.

Introduction

Parents with intellectual and developmental disabilities (IDDs) often need parenting support, but there are few evidence-based programmes adapted to their cognitive needs. Parenting Young Children (PYC), a home-based programme for parents with IDDs, is perceived as beneficial by parents and practitioners, but it is unclear if PYC improves parenting. The purpose of the proposed mixed-methods study is therefore to evaluate the PYC programme for improved parenting in parents with IDDs.

Methods and analysis

The quantitative evaluation will have a multi-centre, pretest-posttest study design and include parents with IDDs (children aged 0–9) in need of adapted parenting support. Goal-attainment in parenting skills, parental self-efficacy and child mental health will be measured outcomes. Interviews will be used to explore the perspectives of parents and children on PYC.

Ethics and dissemination

Particpation is based on informed consent from parents and guardians of the participating children. Ethical approval was granted by the Swedish Ethical Review Authority.

Background: Research on how parents with intellectual and developmental disabilities perceive the Parenting Young Children (PTC) support program for the development of parenting skills is scarce. The study explored parents’ experiences of PYC’s methodology.

Method: Interviews were conducted with 15 Swedish parents (8 mothers, 7 fathers) at risk for child neglect who had received PYC for 6 months or longer. The interviews were analysed with reflexive thematic analysis.

Results: Two main themes, with six subthemes, were identified: “Developing a trusting relationship with the PYC practitioner” and “Tailored support, planning, and training in collaboration.” One overarching theme was also created: “The PYC methodology facilitates learning of parenting skills through a trusting and collaborative process guided by adapted support.”

Conclusion: Parents with intellectual and developmental disabilities perceived the PYC methodology as helpful and well-adapted. The study highlights that learning parenting skills can be facilitated by a collaborative and tailored approach using behavioural teaching strategies.

Background: Safe Environment for Every Kid (SEEK) is one of few evidence-based approaches to identify psychosocial problems and facilitate support to families within pediatric primary care. The Swedish version of SEEK, called BarnSäkert (“Child Safe”), is being evaluated as a complex intervention in the Swedish child health services (CHS) for children aged 0–6 years.

Objective: Assessment of parents’ views of the acceptability and efficacy of the BarnSäkert SEEK model within the CHS in Sweden.

Participants and setting: Mothers and fathers (n = 353) whose children were enrolled in the CHS.

Methods: An anonymous web-based survey posed questions regarding how parents perceived BarnSäkert/SEEK and whether services had been offered, accessed or planned as a result. Efficacy was measured as parents’ reports of an improved life situation or having been helped by the model.

Results: Among parents who discussed their situation with the nurse, 80 % reported that it had helped, 24 % had received help that they otherwise would not have and 20 % that their situation had improved. Appropriateness of the model was scored at 91/100 by mothers and 86/100 by fathers. Logistic regression showed significantly higher odds ratios for efficacy measures and service uptake for parents who were younger, born outside of Sweden or had lower levels of education.

Conclusions: Parents reported that the model was highly acceptable and efficacious in meeting their psychosocial needs. The findings lend support for application of the BarnSäkert/SEEK model in the Swedish CHS as an equitable approach to address psychosocial problems in families with young children.

This article contributes knowledge regarding professionals’ experiences, conceptions, and expectations of a coordinator role in preschools/schools while multiprofessionally collaborating for supporting children "at risk". Data were collected via semi-structured interviews with professionals involved in a project in a Swedish municipality intended to prevent children from getting into difficulties. Procedures for thematic analysis were followed, and Billig’s ideological dilemmas were used as a methodological tool. A coordinator role, assigned to head teachers, emerges as tense where dilemmas need to be addressed. The dilemmas are related to opposed, overarching ideas – education for "all" versus treatment for specific children – which require coordination. This article suggests that dialogues between actors need to be held when opposite positions can be articulated. To initiate and maintain such dialogues, a coordinator role is important.

Nyanlända föräldrar kommer med kompetenser, resurser och med förmåga att ta hand om sig själva och sin familj. Det finns dock utmaningar för en del nyanlända föräldrar med att navigera i det nya landet t ex. när det gäller föräldraskap. Den nationella strategin för ett stärkt föräldraskapsstöd framhåller vikten av att erbjuda ett evidensbaserat föräldraskapsstöd för flera arenor i syfte att nå ut till alla föräldrar, särskilt nyanlända föräldrar. En arena som inte tidigare har provats för föräldraskapsstöd  är svenska för invandrare (SFI-) verksamheten. I detta projekt har vi undersökt genomförbarheten och utfallet av ett integrerat föräldraskapsstödi SFI-undervisning enligt programmet International Child Development Program (ICDP).

Resultatet visar att SFI-verksamheten är en arena där föräldraskapsstöd enligt ICDP-programmet kan implementeras för att tidigt stödja nyanlända grupper i deras föräldraskap och integration. Det är dock viktigt att politiker, chefer och medarbetare ser värdet av att genomföra det. Resultaten understryker vikten av att det finns en koordinator som fungerar som en spindel i nätet och som underlättar för lärarna vid planering och genomförande av ICDP-kursen.

Enkätstudien till deltagarna på ICDP-kursen visade att den sociala inkluderingen förbättrades efter ICDP-kursen. Tilliten till föräldraskapet ökade och deltagarna upplevde att de blev tryggare i sitt föräldraskap. Även samspelet mellan föräldrar och barn förbättrades. För SFI-lärare och studiehandledare innebar genomförande av föräldrakursen (ICDP) utveckling av personlig och professionell kompetens, ökad förståelse för elevers situation samt ett förbättrat samspel mellan dem och deras elever.

Background: The Safe Environment for Every Kid (SEEK) model was developed to address psychosocial risk factors (financial worries, depressive symptoms, major parental stress, alcohol misuse and intimate partner violence) in the pediatric primary care setting but has not been evaluated from the parents’ perspective. To further investigate the usefulness of SEEK, it is important to explore how parents perceive the model.

Objective: The aim of the present study was to explore parents’ perceptions of the SEEK model as a part of regular health visits in the Child Health Services in Sweden.

Participants and setting: Eighteen parents (13 women and five men) in two Swedish counties participated in the study.

Methods: Semi-structured telephone interviews were conducted, and the resulting data were analyzed using reflective thematic analysis.

Results: Three themes were identified: Acceptance and understanding of the SEEK model in the child health services, The questionnaire as a bridge to a dialogue, and Feeling trust in the system and the child health nurse’s professional competence. Further, an overarching theme was created that encompassed a core meaning of all three themes; SEEK provides a process-oriented framework to receive support in parenting with a focus on child health.

Conclusions: The study showed that parents express both acceptance and understanding of the SEEK model and they perceive that the model provides an avenue for repeated dialogues about the family’s situation during the child’s upbringing and an opportunity to access support if needed.

Boken syftar till att ge ett mångsidigt perspektiv på det sociala och kurativa arbetet med personer med funktionsnedsättning, utifrån ett livsloppsperspektiv.

Boken består av tre delar. Den första delen utgår från ett samhällsperspektiv, där etiska och rättsliga aspekter lyfts fram, liksom hälsoaspekter för personer med funktionsnedsättning. Den andra delen utgår från ett individ- och familjeperspektiv med fokus på barnaåren fram till ungdomsåren. Den sista delen berör ung vuxenperiod upp till åldrandet.

Background: Parents with intellectual and developmental disabilities (IDDs) often need parenting support, but there are few evidence-based support programs adapted to these parents’ cognitive needs. Parenting Young Children (PYC) is a home-based parenting support program developed for parents with IDDs in Australia and has since been implemented in Sweden. PYC emphasizes individualized goals, breaking down complex skills into smaller steps, and collaborating with the parents. To investigate the usefulness and acceptability of PYC, it is of vital importance to explore how the intervention is perceived by the parents.

Aim: The aim of the present study was to explore how PYC is perceived by Swedish parents with IDD as in need of adapted parenting support when there is a risk for neglect.

Methods: Parents' experiences of PYC were explored shortly after completing PYC, using individual, semi-structured interviews that are audio-recorded and transcribed. The data were analyzed using thematic analysis. Data collection is ongoing, and so far, 12 of the 15 parents have been interviewed. Participating parents have mild ID or other cognitive difficulties (e.g., ASD) and have children between 0 and 9 years of age.

Findings (preliminary): The parents experienced increased security in parenting, improvements in parenting skills, and strengthened self-confidence. PYC influenced parent-child relationships so that the child's needs were put in focus. The parents also emphasized that their parental competence developed in a trusting, participatory process in which it was important to feel included and treated positively. A prerequisite was that the PYC-social worker cooperates with the parent and is sensitive to the parent’s specific needs and wishes. According to the parents, the PYC-social worker should focus on the relationship between the parent and the PYC-social worker and the parents' knowledge and skills to increase the parent's competence. It was also of vital importance to include the needs of both the child and the parent.