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Publications (10 of 82) Show all publications
Bergman, P., Rusaw, D., Bülow, P. H., Skillmark, M. & Jansson, I. (2023). Effects of arts on prescription for persons with common mental disorders and/or musculoskeletal pain: A controlled study with 12 months follow-up. Cogent Public Health, 10(1), Article ID 2234631.
Open this publication in new window or tab >>Effects of arts on prescription for persons with common mental disorders and/or musculoskeletal pain: A controlled study with 12 months follow-up
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2023 (English)In: Cogent Public Health, E-ISSN 2770-7571, Vol. 10, no 1, article id 2234631Article in journal (Refereed) Published
Abstract [en]

Aims: Involvement in arts has shown potential to promote mental health. Thus, arts may be able to complement conventional healthcare to address common mental disorders (CMD). The aim of this study was to evaluate the long-term effect of a 10-week Arts on Prescription program regarding CMD (stress, anxiety, depression), compared to conventional healthcare. The study also aimed to examine whether CMD differed between groups.

Methods: A quasi-experimental prospective design with intervention and control group and 6- and 12-month follow-up was used to evaluate an Arts on Prescription program in Sweden, focusing on the effects on stress, anxiety, and depression. Participants were on sick leave due to CMD and/or musculoskeletal pain. Data was collected using questionnaires.

Results: The study population consisted of 479 participants (n=247 intervention group, n=232 control group). The result indicates a greater effect size (ŋ) in the intervention group compared to the control group for reduction in stress, anxiety, and depression at follow-up after 12 months. The difference in depression was significant.

Conclusions: The results indicate AoP could be an adjunct to conventional healthcare interventions to address CMD, especially depression.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
culture activities, mental health, participatory arts, social prescription
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hj:diva-62210 (URN)10.1080/27707571.2023.2234631 (DOI)GOA;;897657 (Local ID)GOA;;897657 (Archive number)GOA;;897657 (OAI)
Funder
Futurum - Academy for Health and Care, Jönköping County Council, Sweden
Available from: 2023-08-18 Created: 2023-08-18 Last updated: 2023-08-18Bibliographically approved
Bülow, P. H., Finkel, D., Allgurin, M., Torgé, C. J., Jegermalm, M., Ernsth-Bravell, M. & Bülow, P. (2022). Aging of severely mentally ill patients first admitted before or after the reorganization of psychiatric care in Sweden. International Journal of Mental Health Systems, 16(1), Article ID 35.
Open this publication in new window or tab >>Aging of severely mentally ill patients first admitted before or after the reorganization of psychiatric care in Sweden
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2022 (English)In: International Journal of Mental Health Systems, E-ISSN 1752-4458, Vol. 16, no 1, article id 35Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The concept of deinstitutionalization started in the 1960s in the US to describe closing down or reducing the number of beds in mental hospitals. The same process has been going on in many countries but with different names and in various forms. In Europe, countries like Italy prescribed by law an immediate ban on admitting patients to mental hospitals while in some other European countries psychiatric care was reorganized into a sectorized psychiatry characterized by open psychiatric care. This sectorization has not been studied to the same extent as the radical closures of mental hospitals, even though it entailed major changes in the organization of care. The deinstitutionalization in Sweden is connected to the sectorization of psychiatric care, a protracted process taking years to implement.

METHODS: Older people, with their first admission to psychiatric care before or after the sectorization process, were followed using three different time metrics: (a) year of first entry into a mental hospital, (b) total years of institutionalization, and (c) changes resulting from aging. Data from surveys in 1996, 2001, 2006, and 2011 were used, together with National registers.

RESULTS: Examination of date of first institutionalization and length of stay indicates a clear break in 1985, the year when the sectorization was completed in the studied municipality. The results show that the two groups, despite belonging to the same age group (birthyears 1910-1951, mean birthyear 1937), represented two different patient generations. The pre-sectorization group was institutionalized at an earlier age and accumulated more time in institutions than the post-sectorization group. Compared to the post-sectorization group, the pre-sectorization group were found to be disadvantaged in that their level of functioning was lower, and they had more unmet needs, even when diagnosis was taken into account.

CONCLUSIONS: Sectorization is an important divide which explains differences in two groups of the same age but with different institutional history: "modern" and "traditional" patient generations that received radically different types of care. The results indicate that the sectorization of psychiatric care might be as important as the Mental Health Care Reform of 1995, although a relatively quiet revolution.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2022
Keywords
Deinstitutionalization, Longitudinal, Older people, Sectorization, Severe mental illness
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hj:diva-57967 (URN)10.1186/s13033-022-00544-9 (DOI)000824694400001 ()35831905 (PubMedID)2-s2.0-85134237153 (Scopus ID)GOA;;822622 (Local ID)GOA;;822622 (Archive number)GOA;;822622 (OAI)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, STYA‑2015/0003
Available from: 2022-07-18 Created: 2022-07-18 Last updated: 2023-10-02Bibliographically approved
Bulow, P., Bülow, P. H. & Finkel, D. (2022). DIFFERENCES AND SIMILARITIES OF ELDERLY PERSONS IN SWEDEN WITH A DIAGNOSIS OF PSYCHOSIS OR NON-PSYCHOSIS (SMI). Innovation in Aging, 6(Supplement 1), 794-794
Open this publication in new window or tab >>DIFFERENCES AND SIMILARITIES OF ELDERLY PERSONS IN SWEDEN WITH A DIAGNOSIS OF PSYCHOSIS OR NON-PSYCHOSIS (SMI)
2022 (English)In: Innovation in Aging, E-ISSN 2399-5300, Vol. 6, no Supplement 1, p. 794-794Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Psychiatric care in Sweden is jointly organized by psychiatric practice and municipal social services. To determine who is entitled to support from the municipalities, the concept of “psychiatric disability” was created in connection with psychiatric reform in 1995. Psychiatric disability is a poorly identified concept and in Sweden, a person has severe mental illness (SMI) if they have difficulties in carrying out activities in crucial areas of life, these difficulties are caused by a mental disorder, and they are prolonged. Internationally, SMI is often synonymous with psychosis, but in Sweden other severe psychiatric conditions are included, but not dementia. Both practically and ethically, the unclear definition of SMI is a problem because it determines whether a person is granted interventions and what forms the interventions take. We investigated similarities and differences in people defined as SMI, divided into two groups, psychosis (Nf222) and non-psychosis (Nf253). Adults with SMI aged 65 or over (in 2016) have been assessed using data from four surveys carried out between 1996 and 2011, as well data available from national registers. People with psychosis had worse functional levels on the Global Assessment of Functioning and more unmet needs, according to Camberwell Assessment of Needs. However, differences between psychosis and non-psychosis groups varied across measures (e.g., education, income, living situation) and results differed depending on age at onset, year of first admission to a mental hospital, and length of institutionalization. These variables had a greater impact on the similarities and differences between measures than the diagnosis itself.

Place, publisher, year, edition, pages
Oxford University Press, 2022
National Category
Geriatrics
Identifiers
urn:nbn:se:hj:diva-60007 (URN)10.1093/geroni/igac059.2867 (DOI)000913044004042 ()
Available from: 2023-03-21 Created: 2023-03-21 Last updated: 2023-03-21Bibliographically approved
Wilińska, M., Bülow, P. H., Keet, A. & Esau, M. C. (2022). “Personally, I like it. Professionally, it does not make sense” – social work students in South Africa and Sweden making sense of internationalization. Nordic Social Work Research, 12(5), 654-665
Open this publication in new window or tab >>“Personally, I like it. Professionally, it does not make sense” – social work students in South Africa and Sweden making sense of internationalization
2022 (English)In: Nordic Social Work Research, ISSN 2156-857X, E-ISSN 2156-8588, Vol. 12, no 5, p. 654-665Article in journal (Refereed) Published
Abstract [en]

Internationalization of higher education and international social work are commonly accepted as positive developments. However, the quest for creating international knowledge and programmes is not free from difficulties. In this article, we problematize the process of internationalizing social work programs through the perspective of social work students. With two study sites, one in Sweden and one in South Africa, we discuss the meaning and challenges associated with internationalization by drawing on the emerging disparity between personal and professional points of view. We conclude by reflecting upon the role of social work educators in translating the ideas of internationalization to the future social workers.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
Internationalization; international social work; students
National Category
Social Work
Identifiers
urn:nbn:se:hj:diva-51330 (URN)10.1080/2156857X.2020.1861971 (DOI)001026169800005 ()2-s2.0-85145502749 (Scopus ID)HOA;intsam;51330 (Local ID)HOA;intsam;51330 (Archive number)HOA;intsam;51330 (OAI)
Available from: 2020-12-22 Created: 2020-12-22 Last updated: 2023-08-18Bibliographically approved
Lundin, A., Bülow, P. H. & Stier, J. (2021). Assistant Nurses' Positioned Accounts for Prioritizations in Residential Care for Older People. The Gerontologist, 61(4), 573-581
Open this publication in new window or tab >>Assistant Nurses' Positioned Accounts for Prioritizations in Residential Care for Older People
2021 (English)In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 61, no 4, p. 573-581Article in journal (Refereed) Published
Abstract [en]

Background and Objectives: Swedish eldercare is strained by an increased administrative workload, which draws time away from individual care of and interaction with older people. This study explores how eldercare staff, working closely with residents in Swedish special housing (nursing homes), make accounts for how they prioritize work tasks.

Research Design and Methods: Openly structured, thematic interviews were conducted with 12 permanently employed, female assistant nurses, including a group interview with 3 of them. Positioned accounts (small stories) concerning prioritizations due to insufficient resources were analyzed, using Bamberg's three-level positioning analysis.

Results: The analysis shows that the staff take a favorable position toward the older people by distinguishing between care and "the other things."They also justify prioritizations at odds with their care values. The assistant nurses present themselves as doing the best they can in organizationally restricted situations. Organizational demands limit the space for care, giving rise to an idealization of "icing on the cake."Morale is complex in residential care. A narration of "the torn carer"was found as a co-constructed storyline explaining why the staff did not perform eldercare consistent their care values.

Discussion and Implications: When ideals and practice differ, interaction in the peer group becomes important in order to maintain a positive professional identity. "The torn carer"is a way for the staff to escape blame for not living up to care values, but it also victimizes them. Staff could be empowered by a working environment characterized by a reflective practice. 

Place, publisher, year, edition, pages
Oxford University Press, 2021
Keywords
Accounts, Eldercare, Positioning, Small stories, Social work, adult, article, blame (psychology), care behavior, female, housing, human, interview, morality, nurse, nursing home, peer group, resident, residential care, verbal communication, work environment
National Category
Social Work
Identifiers
urn:nbn:se:hj:diva-54091 (URN)10.1093/geront/gnaa154 (DOI)000671118900013 ()33063827 (PubMedID)2-s2.0-85107711484 (Scopus ID)
Note

Special Issue: Workforce Issues in Long-Term Care.

Available from: 2021-07-15 Created: 2021-07-15 Last updated: 2021-07-22Bibliographically approved
Finkel, D., Bülow, P. H., Wilińska, M., Jegermalm, M., Torgé, C. J., Ernsth-Bravell, M. & Bülow, P. (2021). Does the length of institutionalization matter? Longitudinal follow-up of persons with severe mental illness 65 years and older: shorter-stay versus longer-stay. International Journal of Geriatric Psychiatry, 36(8), 1223-1230
Open this publication in new window or tab >>Does the length of institutionalization matter? Longitudinal follow-up of persons with severe mental illness 65 years and older: shorter-stay versus longer-stay
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2021 (English)In: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 36, no 8, p. 1223-1230Article in journal (Refereed) Published
Abstract [en]

Objectives

As part of the process of de-institutionalization in the Swedish mental healthcare system, a reform was implemented in 1995, moving the responsibility for services and social support for people with severe mental illness (SMI) from the regional level to the municipalities. In many ways, older people with SMI were neglected in this changing landscape of psychiatric care. The aim of this study is to investigate functional levels, living conditions, need of support in daily life, and how these aspects changed over time for older people with SMI.

Methods

In this study we used data from surveys collected in 1996, 2001, 2006, and 2011 and data from national registers. A group of older adults with severe persistent mental illness (SMI-O:P) was identified and divided into those who experienced shorter stays (less than 3 years) in a mental hospital (N = 118) and longer stays (N = 117).

Results

After correcting for longitudinal changes with age, the longer-stay group was more likely than the shorter-stay group to experience functional difficulties and as a result, were more likely to have experienced 're-institutionalization' to another care setting, as opposed to living independently.

Conclusions

The length of mental illness hospitalization has significant effects on the living conditions of older people with SMI and their ability to participate in social life.

Place, publisher, year, edition, pages
John Wiley & Sons, 2021
Keywords
ageing, deinstitutionalization, longitudinal studies, re-institutionalization, severe mental illness, severe persistent mental illness
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-51985 (URN)10.1002/gps.5515 (DOI)000621120500001 ()33577096 (PubMedID)2-s2.0-85101520533 (Scopus ID)HOA;;725389 (Local ID)HOA;;725389 (Archive number)HOA;;725389 (OAI)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2015‐00223
Available from: 2021-03-04 Created: 2021-03-04 Last updated: 2021-12-29Bibliographically approved
Börjesson, U., Skillmark, M., Bülow, P. H., Bülow, P., Vejklint, M. & Wilińska, M. (2021). “It’s about Living Like Everyone Else”: Dichotomies of Housing Support in Swedish Mental Health Care. Social Inclusion, 9(3), 276-285
Open this publication in new window or tab >>“It’s about Living Like Everyone Else”: Dichotomies of Housing Support in Swedish Mental Health Care
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2021 (English)In: Social Inclusion, ISSN 2183-2803, E-ISSN 2183-2803, Vol. 9, no 3, p. 276-285Article in journal (Refereed) Published
Abstract [en]

The deinstitutionalization of psychiatric care has not only altered the living conditions for people with severe mental illness but has also greatly affected social services staff. In the Mental Health Act launched by the Swedish government in 1995, a new kind of service called ‘housing support’ and a new occupational group, ‘housing support workers,’ was introduced. However, housing support does not currently operate under any specific guidelines regarding the content of the service. This study explores housing support at local level in various municipalities of one Swedish county. The data is based on discussion with three focus groups: care managers, managers for home and community‐based support, and housing supporter workers. The perspective of institutional logics as a specific set of frames that creates a standard for what should or could be done, or alternately what cannot be questioned, is applied to analyze the constructed meaning of housing support. The meaning of housing support is constructed through three dichotomies: process and product, independence and dependence, and flexibility and structure. These dichotomies can be understood as dilemmas inherent in the work and organizing of housing support. With no clear guidelines, the levels of organizational and professional discretion create a space for local flexibility but may also contribute to tremendous differences in defining and implementing housing support. We discuss the potential consequences for housing support users implied by the identified discrepancies.

Place, publisher, year, edition, pages
Cogitatio, 2021
Keywords
focus groups; housing support; institutional logics; welfare work
National Category
Social Work
Identifiers
urn:nbn:se:hj:diva-54068 (URN)10.17645/si.v9i3.4314 (DOI)000691063200011 ()2-s2.0-85113438568 (Scopus ID)GOA;;54068 (Local ID)GOA;;54068 (Archive number)GOA;;54068 (OAI)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2019‐01475
Available from: 2021-07-13 Created: 2021-07-13 Last updated: 2021-09-09Bibliographically approved
Bergman, P., Jansson, I. & Bülow, P. H. (2021). ‘No one forced anybody to do anything – and yet everybody painted’: Experiences of Arts on Referral, a focus group study. Nordic Journal of Arts, Culture and Health, 3(1-2), 9-20
Open this publication in new window or tab >>‘No one forced anybody to do anything – and yet everybody painted’: Experiences of Arts on Referral, a focus group study
2021 (English)In: Nordic Journal of Arts, Culture and Health, E-ISSN 2535-7913, Vol. 3, no 1-2, p. 9-20Article in journal (Refereed) Published
Abstract [en]

Arts on Referral (AoR) is a complementary intervention used to support people who are on sick leave due to common mental disorders (CMD) and/or musculoskeletal pain, challenging public health.

Aim: To deepen the understanding of how AoR works from a health-promoting perspective and how people with CMD and/or musculoskeletal pain experience AoR.

Design: The study adopted a qualitative approach. Thirty women (21–65 years old) participated in a total of five focus groups after the AoR intervention, which consisted of two sessions a week for ten weeks.

Findings: A qualitative content analysis of the focus group identified four categories: 1. Place of belonging including descriptions of social connectedness and understanding; 2. Experiences of AoR as a respite from demands; 3. Arts activities offering challenge and reward; and 4. Contributing to health-promoting changes. The findings were discussed in the light of Wenger’s concept of community of practice and Csikszentmihalyi’s concept of flow.

Value: This study describes how AoR contributed to health-promoting changes by offering a place of belonging, free from demands but still with opportunities to challenge oneself and explore new skills. Findings suggest that AoR can be helpful in improving mental wellbeing and feelings of belonging.

Place, publisher, year, edition, pages
Universitetsforlaget, 2021
Keywords
arts and health, Arts on Prescription (AoP), mental health, participatory arts, social inclusion
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hj:diva-59843 (URN)10.18261/issn.2535-7913-2021-01-02-02 (DOI)POA;;59843 (Local ID)POA;;59843 (Archive number)POA;;59843 (OAI)
Available from: 2023-02-16 Created: 2023-02-16 Last updated: 2023-02-16Bibliographically approved
Bülow, P. H. & Wilińska, M. (2021). Sympathy and micropolitics in return-to-work meetings. In: K. Juhila, T. Dall, C. Hall & J. Koprowska (Ed.), Interprofessional collaboration and service user participation: Analysing meetings in social welfare (pp. 141-169). Bristol: Polity Press
Open this publication in new window or tab >>Sympathy and micropolitics in return-to-work meetings
2021 (English)In: Interprofessional collaboration and service user participation: Analysing meetings in social welfare / [ed] K. Juhila, T. Dall, C. Hall & J. Koprowska, Bristol: Polity Press, 2021, p. 141-169Chapter in book (Refereed)
Place, publisher, year, edition, pages
Bristol: Polity Press, 2021
Series
Research in Social Work
National Category
Social Work
Identifiers
urn:nbn:se:hj:diva-52480 (URN)2-s2.0-85106085756 (Scopus ID)9781447356639 (ISBN)9781447356660 (ISBN)9781447356653 (ISBN)
Available from: 2021-05-18 Created: 2021-05-18 Last updated: 2021-06-01Bibliographically approved
Bülow, P. H., Topor, A., Andersson, G., Denhov, A. & Stefansson, C.-G. -. (2021). The Stockholm Follow-up Study of Users Diagnosed with Psychosis (SUPP): A 10-year Follow-up 2004–2013. Community mental health journal, 57, 1121-1129
Open this publication in new window or tab >>The Stockholm Follow-up Study of Users Diagnosed with Psychosis (SUPP): A 10-year Follow-up 2004–2013
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2021 (English)In: Community mental health journal, ISSN 0010-3853, E-ISSN 1573-2789, Vol. 57, p. 1121-1129Article in journal (Refereed) Published
Abstract [en]

Since the 1970s, psychiatric care in the western world has undergone fundamental changes known as de-institutionalisation. This has changed the living conditions for people with severe mental illness. The purpose of this study was to investigate the living conditions and utilisation of care and social services for a group of people in Sweden with diagnosis of psychosis over a 10-year period, 2004–2013. During this period, psychiatric care decreased at the same time as interventions from the social services increased. Half of the persons in the studied group did not have any institutional care, that is, neither been hospitalised nor dwelling in supported housing, during the last 5 years, and just over 20% had no contact with either psychiatry or the municipality's social services during the last 2 years of the investigated period.

Place, publisher, year, edition, pages
Springer, 2021
Keywords
De-institutionalisation, Longitudinal study, Psychiatric care, Severe mental illness, Social services
National Category
Psychiatry
Identifiers
urn:nbn:se:hj:diva-51048 (URN)10.1007/s10597-020-00740-2 (DOI)000589561700001 ()33191458 (PubMedID)2-s2.0-85096019332 (Scopus ID)HOA;intsam;1503772 (Local ID)HOA;intsam;1503772 (Archive number)HOA;intsam;1503772 (OAI)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-0117
Available from: 2020-11-25 Created: 2020-11-25 Last updated: 2022-01-20Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7341-945X

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