This study explores and analyzes how adult women in Sweden exposed to childhood maltreatment describe wellbeing, by using a thematic analysis of 22 semi-structured interviews with women maltreated as children. The results show that wellbeing was described as relative to both social norms and the childhood experiences and constituted four dimensions: Material and/or economic; Social and relational;Emotional; and Physical and/or mental. This study concludes that it is important to consider the relative and multiple ways wellbeing can be experienced and understood and to problematize norms of wellbeing, acknowledging the various ways people appraise their lives.

Background/Objectives

Previous research shows that the stronger the sense of coherence (SOC) the healthier behaviour. A strong SOC seems to be related to lower consumption of drugs and smoking, more frequent physical exercises and healthier food choices. Further it is established by previous research that there is a difference in health behaviour between socioeconomic groups. Individuals with lower socioeconomic status (SES) smoke to greater extent, have more sedentary lifestyle and make unhealthier food choices than individual with higher SES. The evidence regarding the interactive relations of SOC and SES to health behaviour or the potential mediating role of SOC in the relationship between SES and health behaviour is more unclear. In order to explore this, there is a need of systematic reviews of the evidence concerning SOC and health behaviour and interactions with SES.

Thus, the objective of this study is to explore and synthesize empirical findings on the relationship between SOC and health behaviour among adults. Further the aim is to explore to what extent interactions with SES is considered in the studies of SOC and health behaviour.

 Methods

The study is descriptive and analytical with a systematic integration of the contemporary knowledge base on the salutogenic research focusing on the relationship between sense of coherence and health behaviour among adults and interrelations with socioeconomic status. The review covers scientific publications as well as doctoral theses published 2008–2018. The review is systematic in the sense that all the included papers will be critically examined and analyzed according to (1) the study objective, (2) the study designs and methods for analysis and, (3) the applicability and practical use of the results.

 Results

Expected outcomes of this study will be established state of the art regarding the relationship between sense of coherence and health behavior and interrelations with socioeconomic status. Further the results will identify knowledge gaps important to address in future research.

Discussion

The potential contribution of the synthesized knowledge to achieve a sustainable and equal development of health will be discussed as well as to what extent health inequalities can be explained or understood by SOC.

The first years of life and the family context are key to the promotion and protection of children’s health and well-being, emphasizing the need for interventions aimed to support families with young children. This review aimed to explore the effectiveness of early childhood interventions developed for promoting mental health and parenting among families with young children in the Nordic countries. Six electronic databases were systematically searched, and 20 articles covering 16 studies applying various quantitative and qualitative methods met the study inclusion criteria. The studied interventions were assessed as universal health-promoting interventions and health-promoting interventions with elements of prevention. Outcomes of interest encompassed mental health, related risk and protective factors among the parents and/or the children, or child-parent interaction. The results from studies applying statistical methods show significant improvements in parents’ self-efficacy, self-esteem, and parental satisfaction, while few improvements in parents’ social support or parental relationship were identified. Improvements in social support and parental relationships were however reported in qualitative studies. Most quantitative studies reporting on parents’ mental health problems and stress found a significant decrease, and qualitative studies highlighted experienced positive effects on mental health and well-being. The majority of studies reporting on children’s mental health and/or development as well as strengths and difficulties indicated a statistically significant positive development. No significant changes were however found for existing behaviora lproblems. The majority of studies examining parenting strategies and/or parent-child interaction found significant positive changes after the interventions. In sum, although findings are heterogeneous, early childhood interventions show various positive effects on the parenting and mental health of both children and their parents. The fact that different types of initiatives have been developed and implemented can be seen as an advantage, considering the varying needs and expectations of different families.

PURPOSE: One of the main tasks of a child health care nurse is to assess and promote a responsive interaction and secure connection between children and their parents for the future. This study aims to develop an understanding of Swedish child health care nurses´ experiences of assessing and promoting responsive interaction between parents and children.

DESIGN AND METHOD: A qualitative interview study using an inductive approach was implemented. Eleven nurses were interviewed (range: 30-58 min) during the period March to August 2016, and the transcripts were analysed using qualitative content analysis according to Graneheim and Lundman.

RESULTS: Three categories emerged: Interpreting signals in parent and child behaviour, Reinforcing the parents in their role and Feeling inadequate as professional. Interpreting signals in parent and child behaviour was described fundamental when promoting responsive interaction. Further reinforcing the parents in their role was described central. The child health care nurses also described how they often felt inadequate in promoting responsive interaction.

CONCLUSIONS: Assessing and promoting responsive interaction is an important but challenging task which requires extensive knowledge and good communication skills. The child health care nurses express their insufficiency in that regard.

PRACTICE IMPLICATIONS: A targeted education and sufficient time for each visit at the child health care center should be allocated to facilitate the important work on parenting and child interaction and to enhance nurses' feelings of managing their work.

Background: The five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) have long traditions of social welfare policies that have eradicated poverty as part of their goals. The purpose of this study was to increase our understanding of why child poverty is still significant in the Nordic countries despite existing strategies. Methods: A qualitative analysis of Nordic government documents and reports between 2007 and 2019 was carried out to track changes in public health priorities and political measures and to determine the similarities and differences between the five countries. Results: In all countries, most of the measures were universal, such as benefits during pregnancy, paid parental leave before and after the child was born, paid parental leave related to children’s sickness, child allowances, day care, free health care for children and support for disabled children. National policies aimed to reduce social inequalities and child poverty exist in all five countries, but unaffordable housing, unequal disposable family income distribution and unequal income distribution at local municipality levels seem to be obstacles to reaching national policy goals. Conclusions: Despite comprehensive universal measures to eradicate child poverty, inequalities are significant and increasing in some of the Nordic countries. This might be due to a lack of proportional universalism, where universal measures are in place in all Nordic countries, but with a lack of scale and intensity proportional to the children and families at risk. The significance of eliminating social inequalities needs to be emphasised at the local level.  

Schools are important arenas for mental health promotion initiatives. School nurses have the opportunity and ability to support and promote students’ mental health, but their role and practices have been perceived as somewhat unclear. Therefore, the aim of this study was to explore school nurses’ mental health promotion practices. A total of 12 scientific studies were synthesized through a meta-ethnographic approach. The overarching results of the synthesis show that school nurses’ mental health promotion practices are largely about balancing and combining the students’ needs with different professional perspectives, competencies, and conditions. The school nurses perceived that they had the power to influence their practices through a variety of ways, highlighting the importance of letting the students’ needs guide the practices. Yet, at the same time they described feelings of powerlessness because of the different organizational structures that were hindering their mental health promotion practices.

BACKGROUND: The home, the family and the parents represent a context of everyday life that is important for child health and development, with parent-child relationships highlighted as crucial for children's mental health. Time pressure is an emerging feature of modern societies and previous studies indicates that parents with children living at home experience time pressure to a greater extent than people with no children living at home. Previous studies of children's mental health in relation to parents' time pressure are lacking. Hence, the purpose of this study was to examine the association between parents' subjective time pressure and mental health problems among children in the Nordic countries as well as potential disparities between boys and girls in different age groups.

METHODS: 4592 children, aged 4-16 from Denmark, Finland, Norway and Sweden, participating in the 2011 version of the NordChild study, were included. The Strength and Difficulties Questionnaire was used to measure children's mental health and associations to parents' time pressure were assessed by multiple logistic regression analysis.

RESULTS: Among children of parents experiencing time pressure, 18.6% had mental health problems compared to 10.1% among children of parents experiencing time pressure not or sometimes. The odds of mental health problems were higher among both boys (OR 1.80 95% CI 1.32-2.46) and girls (OR 1.95 95% CI 1.42-2.66) if their parents experienced time pressure when adjusted for financial stress. The highest prevalence of mental health problems in the case of parental time pressure was found among girls 13-16 years old (23.6%) and the lowest prevalence was found among boys 13-16 years old (10.7%).

CONCLUSIONS: In this study an association between parents' subjective time pressure and increased mental health problems among children was found. Given that time pressure is a growing feature of modern societies, the results might contribute to an explanation as to mental health problems are common among children in the Nordic countries in spite of otherwise favourable conditions. Additional research on the linkage between parents' experienced time pressure and children's and adolescents' mental health problems is needed to confirm the novel findings of this study.

The aim of this study was to use Bronfenbrenner’s ecological theory to investigate adolescents’ school connectedness and family climate as potential predictors of depressiveness in adulthood.

Background:Foundations for mental health are laid early in family and school life. Family climate embraces the emotional connections within a family, and school connectedness embraces both functional and affective dimensions of relationship with school. Based on the lack of theory-driven and longitudinal epidemiological studies addressing public mental health, the aim of this longitudinal study was to investigate the associations between adolescents’ school connectedness, family climate and depressiveness in adulthood, by relying on Bronfenbrenner’s ecological theory.

Methods:The data are from the Northern Swedish Cohort, and the sample consists of 481 women and 526 men born in 1965 who participated in data collection at age 16, 21, 30 and 43. The generalized linear model method with random intercepts was used to examine the associations between family climate and school connectedness and depressiveness in adulthood.

Results: Poor school connectedness was associated with depressiveness in adulthood [β = 0.038 (95% CI 0.018–0.058) P ≤ 0.001], but poor family climate was not [β = 0.014 (95% CI −0.004–0.032)]. No difference in associations was observed between those experiencing social/material adversities in adolescence.

Conclusions: This study shows that poor school connectedness in adolescence can affect depressiveness in adulthood. The study confirms the complex processes that determine mental health and proposes a theoretical approach appealing to public mental health research. In addition, this study concludes that more life-course studies are needed to advance the knowledge of the mechanisms behind the associations between family climate and school connectedness and depressiveness in adulthood.

BACKGROUND:  The Nordic welfare system has been acknowledged as favourable for children, successfully contributing to low child mortality and poverty rates. Nevertheless, mental health problems among children and adolescents are common and the economic situation of the family has been highlighted as an important determinant. In spite of similar social, political and cultural structures, the Nordic countries differ; Iceland was most affected by the global financial crisis in 2008. The aim of this study was to examine potential differences in parental financial stress and the associations to child mental health between the Nordic countries as well as age and gender differences.  METHODS:  The study sample consisted of 6330 children aged 4-16 years old included in the 2011 version of the Nordic Study of Children's Health, Wellbeing and Quality of life. The Strengths and Difficulties Questionnaire was used to measure mental health problems.  RESULTS:  In Iceland, 47.7% of the parents reported financial stress while ≤20% did so in the other countries except for Finland (33.5%). However, in case of parental financial stress the OR of mental health problems comparing children to parents with and without financial stress was significantly lower among the Icelandic children (OR 1.60, 95% CI 1.15-2.24) than among the others: Denmark OR 3.07 (95% CI 2.15-4.39), Finland OR 2.28 (95% CI 1.60-3.25), Norway OR 2.77 (95% CI 1.86-4.12), Sweden OR 3.31(95% CI 2.26-4.86). No significant age or gender differences in the ORs were observed.  CONCLUSIONS:  Besides socioeconomic situation, relative deprivation should be considered an important determinant of child mental health.

Som generation beskrivs dagens unga värdera sociala relationer högre och prioritera välbefinnande och lycka jämfört med tidigare generationer (1). De anses vara öppnare och mer toleranta men också mindre optimistiska då de i stor utsträckning har upplevt negativa världshändelser (2,3). Att ha en positiv syn på framtiden är en viktig aspekt av välbefinnande, men vad innebär positiv syn på framtiden för dagens unga och vad behöver de för att kunna ha en positiv syn på framtiden?

Metod

I detta projekt presenteras delar av resultaten från en större studie med syfte att undersöka ungas uppfattningar om psykiska besvär och psykiskt välbefinnande. Individuella intervjuer genomfördes med 33 personer mellan 16 och 25 år och analyserades med kvalitativ innehållsanalys (4,5).

Resultat

Framtid tolkades av de unga som alltifrån det stundande sommarlovet till det som händer om flera år. De relaterade positiv syn på framtiden till en variation av erfarenheter så som: att känna tilltro; inneboende optimism och livslust; att ha mål att sträva mot; och saker utanför den egna makten. Möjligheten att forma framtiden själv och inte styras för mycket av andras förväntningar och krav upplevdes viktigt för att kunna ha en positiv syn på framtiden.

Background: A significant proportion of individuals exposed to maltreatment in childhood adapt positively in adulthood despite the adversities, i.e., show resilience. Little is known about resources and processes related to adulthood that promote resilience. Since women are overrepresented as victims of intrafamilial violence, understanding resilience among adult women is important. Objective: To explore experiences of resilience among adult women who perceive well-being and well-functioning although being exposed to maltreatment during childhood. Participants and Setting: This study included 22 women with experiences of childhood maltreatment, mean age of 48 years, living in Sweden. Methods: Individual interviews were conducted and analyzed according to constructivist grounded theory. Results: The process of resilience was experienced as an ongoing endeavor to live, not only survive, an internal process that interacted with external processes involving social relations and conditions. This endeavor was built on four interrelated resources: establishing and maintaining command of life; employing personal resources; surrounding oneself with valuable people; and reaching acceptance. These worked together, not in a linear or chronological order, but in up and down ways, turns and straight lines (now and then), through the process from maltreatment to well-being. Conclusion: Resilience was found to rest on intrapersonal and interpersonal resources. Individual's inherent capabilities can be, depending on life circumstances and available resources, realized in a way that promote well-being and well-functioning despite severe adversities. Therefore, public health initiatives, social services, and policies should provide conditions that help women maltreated in childhood to live fully rather than merely to survive.

BACKGROUND: Childhood maltreatment has detrimental health consequences. Risk for economic marginalization in adulthood is less clear.

OBJECTIVE: To assess prospective associations between sexual abuse, paternal rejection and maternal rejection in childhood and indicators of economic marginalization. We also examined whether these associations were moderated by the adult women's own education and social support.

PARTICIPANTS AND SETTING: A population-based cohort of 643 Swedish women aged 20-25 were asked to retrospectively report on childhood maltreatment. Information on economic marginalization was obtained from register follow-up until 2017.

METHODS: Cox proportional hazard regression was used to assess the associations between childhood maltreatment and incident economic marginalization, and whether these associations were modified by the women's education and social support in adulthood. Regression models were adjusted for parental characteristics and the women's contentment with life at examination.

RESULTS: Sexual abuse increased the risk of financial welfare assistance and disability pension, but no association with long-term unemployment was observed. Paternal but not maternal rejection was associated with excess risk of long-term unemployment, financial welfare assistance, and disability pension. Social support in adulthood did not moderate the associations, but associations between paternal rejection and long-term unemployment were stronger among women with university education than among women with less education.

CONCLUSIONS: This study found childhood sexual abuse and paternal rejection as risk factors for economic marginalization among adult women. Future studies should investigate the reasons for the differential impact of paternal and maternal rejection and the excess risk among highly educated women.

From a salutogenic perspective, relational and reflective competencies are key to the success of competence building. Reflecting on and exploring one’s (life) experience in a continuous learning process can enhance salutogenic competence.

This chapter, whose authors have many years of experience building health professionals’ salutogenic competence, is nicely illustrated with teaching and coaching examples drawn from (a) a master’s programme for students in various health professions, (b) salutogenic talk-therapy groups, (c) students in health promotion training programmes, and (d) on-the-job training of healthcare professionals working in childcare services.

The chapter discusses the concept of “self-tuning,” referring to habitual self-sensitivity, reflection, and mobilising of resources, which can play a central role in all types of training. This chapter emphasises that trainers should strive to “live the talk,” developing their personal salutogenic capacity – in other words, do what you teach and be what you teach.

AIM: The aim of this study was to explore young people's experiences of resources and strategies for promoting their mental health.

METHODS: Individual interviews with 33 people aged 16-25 years were conducted using a method inspired by cognitive interviewing, which combines think aloud techniques with probing questions. The interviews were based on the young people's reflections of the questions in the Swedish national public health survey. Data were analysed with reflexive thematic analysis.

RESULTS: The resources and strategies that the young people in this study described as important for promoting mental well-being are related to societal prerequisites needed to navigate life; to their immediate surroundings, including social interactions; and to the young people themselves. These resources and strategies are presented under the following three themes: prerequisites for navigating life, social interactions on one's own terms, and who I am and what I can do.

CONCLUSIONS: Young people have a variety of resources and strategies of their own available for promoting mental well-being. However, they cannot promote mental health just on their own; access to social networks and the opportunity to share thoughts and feelings are central. Further, to promote mental health, young people need good social conditions, knowledge, and support from adults so that the existence they struggle to navigate feels comprehensible, manageable and meaningful.

Background: Increasing mental health problems among young people are frequently reported. There is also a growing discussion about whether this increase reflects actual mental health problems, or if young people have more limited abilities to deal with normal challenges in life. From a social justice perspective, young people’s own thoughts and experiences need to be considered when mental health promotion among young people is addressed. 

Purpose: The purpose of this study was to describe young people’s experiences of promoting aspects for mental well-being.

Methods: Individual interviews were conducted with 33 youths aged 16 to 25 years. The interviews were based on the mental well-being items used in the national public health survey ‘Health at equal terms’, annually conducted by The Public Health Agency of Sweden. Qualitative content analysis was used to capture the youth´s experiences.

Findings: Preliminary findings describe promoting aspects for mental well-being as; feeling involved in social contexts, having support from loved ones, receiving help from others, feeling significant as a person, being listened to, having an inner strength, feeling that one’s life is meaningful, and reasonable expectations from oneself and those around.

Conclusion: Findings show that both internal and external aspects are important for promoting mental well-being among young people. Some aspects are beyond their control, which indicates that society needs to create prerequisites for young people to develop mental well-being.

Despite high prevalence and severe consequences for health and wellbeing, emotional neglect (EN) in childhood is a neglected topic in epidemiological research. To enable prevention of neglect knowledge is important about conditions related to EN such as parental individual characteristics and social/economic situation. Aim to investigate the relationship between parental socioeconomic position (SEP), psychological problems, and EN in childhood.The sample comprised Swedish women, N = 976, mean age 22. EN was assessed by five indicators: maternal/paternal rejection, maternal/paternal lack of time, and occurrence of domestic violence. The associations between parental SEP/psychological problems and EN were examined by logistic regressions.The odds of experiencing domestic violence in childhood was higher among women with parents with low (OR 3.1 95% CI 1.1-8.5) or medium SEP (OR 3.4 95% CI 1.7-6.9). Women who reported maternal psychological problems had higher odds of maternal rejection (OR 6.8 95% CI 3.5-13.0), maternal lack of time (OR 2.4 95% CI 1.2-5.0) and paternal rejection (OR 1.9 95% CI 1.1-3.5). Women who reported paternal psychological problems had higher odds of perceiving their father as rejecting (OR 4.0 95% CI 2.1-7.7), not having enough time for them (OR 4.9 95% CI 2.3-10.6), and experiencing domestic violence (OR 4.9 95% CI 2.1-11.6).Lower SES was not related to EN in form of parental rejection or lack of time but to the occurrence of domestic violence. Parental psychological problems were related to all indicators of EN but differently among mothers and fathers. Public health initiatives aiming at supporting parents should also embrace parental psychological wellbeing.Emotional neglect was clearly related to parental psychological problems but not parental socioeconomic status.Gendered structures need to be considered in studies of emotional neglect.

BACKGROUND: Despite the high prevalence and severe consequences for health and wellbeing, epidemiological research of neglected emotional needs during childhood is scarce and little is known about its relation to parental socioeconomic position (SEP). This study investigates the prevalence of family violence and parental unavailability in childhood and its association with parental SEP and parental psychological problems in four strata of young Swedish women examined 1990, 1995, 2000, and 2013.

METHOD: The sample comprised 976 women (mean age 22, range 20-25) living in Sweden. Secular trends for family violence, parental rejection and unavailability were analyzed using logistic regression as a function of year of examination. The associations with parental SEP and parental psychological problems were assessed using logistic regression with results in terms of odds ratios (OR) and 95% confidence intervals.

RESULTS: Gendered patterns were observed in the associations between parental psychological problems and family violence and parental unavailability. Maternal psychological problems were associated with maternal rejection OR 6.8 (3.5-13.0), maternal lack of time OR 2.4 (1.2-5.0), and paternal rejection OR 1.9 (1.1-3.5). Paternal psychological problems were associated with paternal rejection OR 4.0 (2.1-7.7), paternal lack of time OR 4.9 (2.3-10.6), and experiencing family violence OR 4.9 (2.1-11.6). Low and medium parental SEP were associated with experience of family violence in childhood OR 3.1 (CI 1.1-8.5) and OR 3.4 (1.7-6.9), respectively. No changes between 1990 and 2013 were observed for the prevalence of any of the outcomes.

CONCLUSIONS: A stable prevalence of family violence and parental unavailability was reported by young women examined between 1990 and 2013. Lower socioeconomic position was associated with family violence while the association with parental unavailability was non-significant. Gendered patterns were observed in the association between parental psychological problems and family violence, where paternal but not maternal psychological problems were associated with family violence. Further, maternal psychological problems were associated with paternal rejection while paternal psychological problems were not associated with maternal rejection. Gendered patterns of parental unavailability need further studies.

Longitudinal assessment is useful for tracking patterns of alcohol use over time. Non-response is a common feature of longitudinal design and can bias estimates of alcohol use if there exist systematic differences between respondents and non-respondents. We investigated whether alcohol use, health status, and sociodemographic characteristics were determinants of non-response in a longitudinal cohort of women in the general population. We used data from a stratified, random sample of 479 women born in 1925, 1935, 1945, 1955, 1965, and 829 women born in 1970 and 1975, who were initially selected as participants in the Women and Alcohol in Gothenburg project. Results from multivariable logistic regression revealed that problematic alcohol use, depression, poor self-rated physical health, and basic education were associated with increased odds of non-response among women born in 1925, 1935, 1945, 1955, and 1965. Among women born between 1970 and 1975, older age and being unmarried increased the odds of non-response at follow-up. Surprisingly, problematic alcohol use and poor health were not associated with non-response in these younger birth cohorts. This study finding suggests that approaches to improve future survey response rates need to consider factors of greatest relevance to birth year and age.

Aims: This study aimed to identify applied definitions and measurements of economic poverty and to explore the proportionsand characteristics of children and adolescents living in economic poverty in Denmark, Finland, Iceland, Norway andSweden during the last decade and to compare various statistics between the Nordic countries. Methods: Official data fromcentral national authorities on statistics, national reports and European Union Statistics of income and living conditionsdata were collected and analysed during 2015–2016. Results: The proportion of Nordic children living in economic povertyin 2014 ranged from 9.4% in Norway to 18.5% in Sweden. Compared with the European Union average, from 2004 to 2014Nordic families with dependent children experienced fewer difficulties in making their money last, even though Icelandicfamilies reported considerable difficulties. The characteristics of children living in economic poverty proved to be similar inthe five countries and were related to their parents' level of education and employment, single-parent households and – inDenmark, Norway and Sweden – to immigrant background. In Finland, poverty among children was linked in particular tolow income in employed households. Conclusions: This study showed that economic poverty among Nordic familieswith dependent children has increased during the latest decade, but it also showed that poverty rates are notnecessarily connected to families' ability to make their money last. Therefore additional studies are neededto explore existing policies and political commitments in the Nordic countries to compensate families withdependent children living in poverty.