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Common mental disorders such as anxiety, depression and stress-related disorders are increasing worldwide, resulting in long-term sick leave and lower quality of life. Traditional treatment is often insufficient to facilitate the recovery process, and the need for holistic interventions that enable successful recovery is evident. Equine-assisted interventions have shown promising results in health promotion among people with mental disorders, and further research is needed to implement them within the range of available care. The aim of the study is therefore to describe experiences of a therapeutic equine-assisted group intervention for people with common mental disorders on sick leave. The study has a descriptive qualitative design with an inductive approach. Ten participants with common mental disorders on sick leave were interviewed after participating in a 12-week equine-assisted intervention and the data were analysed with conventional content analysis. The analysis generated the overall theme "The equine-assisted group intervention facilitates recovery," which summons the four categories "The environment of the horses contributes to relaxation and an ability to be in the present," "The presence of the horses facilitates supportive relationships in the group," "Interplay with the horses entails physical activity and bodily improvements" and "Emotional interactions with the horses strengthen inner power." In conclusion, equine-assisted interventions have the potential to facilitate recovery for people with common mental disorders by providing relaxation, promoting the ability to be in the present, cultivating supportive relationships and providing physical activity and bodily improvements as well as emotional interactions that strengthen the participants' inner power. [ABSTRACT FROM AUTHOR]

Influenza causes seasonal epidemics of respiratory infection in all parts of the world. Manifestations of influenza range from mild upper to severe lower respiratory tract infection. Medical risk groups are defined by factors predisposing for development of severe disease and are recommended annual vaccination as a protective measure. The previous Swedish treatment guidelines for influenza were issued in 2011, and a review of current evidence was deemed relevant. An important reason to revisit the guidelines is the recent approval of a novel drug for influenza treatment, baloxavir. Updated Swedish evidence-based guidelines created by a group of experts from various research areas, for the management of influenza are presented here. The work has been made in collaboration with the Public Health Agency of Sweden and the Swedish Reference Group for AntiViral therapy (RAV). The updated guidelines include guidelines for diagnostics, treatment and prophylaxis in special groups, including management of pregnant women and children with influenza. A new section about infection control has been added. Pharmacological treatment is covered in detail with regards to indication and dosage. Additionally, drug resistance and environmental aspects are discussed. [ABSTRACT FROM AUTHOR]

Parents of children with autism spectrum disorder and other disabilities report high levels of distress, but systematically evaluated interventions are few. This study aimed to evaluate the feasibility of a novel, manualized Acceptance and Commitment Therapy group intervention (Navigator ACT) in a sample of 94 parents of children with disabilities. Feasibility was measured by treatment completion, credibility, and satisfaction, and preliminary outcomes by using self-rating scales administered at the baseline, post-intervention, and follow-up. The results imply the intervention is feasible in the context of Swedish outpatient habilitation services. A preliminary analysis of the outcome measures suggests that parents experienced significant improvements in well-being. The results indicate that the treatment is feasible and should be evaluated in a randomized controlled trial. [ABSTRACT FROM AUTHOR]

Psychosocial treatments improve outcome in Pediatric bipolar disorder (PBD), but few are developed specifically for adolescents and none has been evaluated in Europe. This study evaluates family-focused cognitive-behavioral therapy for adolescents (ages 13-18) with PBD in routine psychiatric care in Sweden, adapted for teenagers in a European setting from the Child and Family-Focused Cognitive Behavioral Therapy for PBD (ages 8-12) developed in the US. In a repeated-measure open trial, psychosocial functioning, depression, skills and knowledge about PBD, and family climate were assessed at pre-treatment, post-treatment, and after 6 months. Assessments were made by adolescents (n = 45), parents (n = 61) and clinicians. Both group statistics and individual trajectories are reported. Psychosocial function, as rated by parents and clinicians, improved at post-treatment, and parents reported less mania and improved family climate at post-treatment. Both parents and adolescents reported improved skills and knowledge. Most results after treatment showed medium effect sizes. Significant improvements were seen in most individual trajectories, however no change and even deterioration was observed in some. The present trial shows that AFF-CBT is well accepted and associated with improved psychosocial function in adolescents and improved skills and knowledge about PBD in adolescents and their parents. Regarding mood symptoms and family climate the results showed more individual variability, indicating that adjustments in delivery of the treatment according to the unique patient could be of importance. AFF-CBT seems to be a valuable addition to pharmacological treatments in PBD., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Importance: Time management is crucial for managing daily activities but is difficult for many people with neurodevelopmental or mental disorders. Few sustainable interventions have addressed time management in daily life. Objective: To describe the experiences and meaning of attending the Swedish version of the Let's Get Organized (LGO–S) group intervention. Design: Qualitative design with interviews 1 to 4 mo after the completed intervention. Setting: Outpatient psychiatric and adult habilitation clinics. Participants: Twelve adults with neurodevelopmental or mental disorders. Intervention: LGO–S, a manual-based group intervention that focuses on time-management skills. Outcomes and Measures: Semistructured interviews analyzed with qualitative content analysis. All authors took an active part in the analysis process; consensus was reached. Results: The overarching theme, "a roller-coaster process toward control over time in daily life," describes the participants' process during and after intervention. Four main categories describe the meaning of understanding why time management is difficult and how to use tools for improvement, a process of change that was facilitated by the learning environment. Participants described the process as a struggle to take control over time, but they noted that the positive changes in daily life made it worthwhile. Conclusions and Relevance: Participation had a positive impact on daily life. The opportunity for skills training with support over an extended period, a changed view on failure, and the group format appear to be important success factors. What This Article Adds: The LGO–S, with its structured training of time-management skills, contributes to occupational therapy practice with an intervention that clients experience as bringing meaningful and positive changes to daily life functioning. The Swedish version of the LGO, with its structured training of time-management skills, contributes to occupational therapy practice with an intervention that clients experience as bringing meaningful and positive changes to daily life functioning. [ABSTRACT FROM AUTHOR]

Shame and self-stigmatisation are common in adolescents with mental health problems, and can hinder their recovery. Compassion-focussed therapy (CFT) help people address challenging experiences and emotions with courage, wisdom, and care. However, no previous studies have examined whether CFT is helpful for adolescents with mental health problems. The present study aimed to describe lived experiences regarding group-based CFT based on the perspectives of a sample of adolescent girls who were recruited from a child and adolescent psychiatric outpatient clinic in Sweden. In-depth interviews were conducted with six girls, aged 15 to 17, using a reflective lifeworld research approach. The results showed that participating in group-based CFT means gaining the courage to see and accept oneself through meeting with peers who are experiencing similar difficulties. When sharing experiences in a group, new perspectives and an acknowledgement that mental and emotional struggle are normal arise, and a sense of inner peace and belonging emerges. Instead of hiding from society, it is possible to participate in everyday life, ask for help, and asserting oneself. CFT can provide a promising method for empowering young people with mental health problems, helping them feel connected with others, and fostering in them the strength to show their true personalities. [ABSTRACT FROM AUTHOR]

Background: A randomised controlled trial found that a structured mindfulness group therapy (MGT) programme was as effective as treatment as usual (mostly cognitive-behavioural therapy) for patients with a diagnosis of depression, anxiety or stress and adjustment disorders in Sweden (ClinicalTrials.gov: NCT01476371).Aims: To perform a cost-effectiveness analysis of MGT compared with treatment as usual from both a healthcare and a societal perspective for the trial duration (8 weeks).Method: The costs from a healthcare perspective included treatment as usual, medication and costs for providing MGT. The societal perspective included costs from the healthcare perspective plus savings from productivity gains for the trial duration. The effectiveness was measured as quality-adjusted life-years (QALY) using the EQ-5D-5L questionnaire and the UK value set. Uncertainty surrounding the incremental costs and effects were estimated using non-parametric bootstrapping with 5000 replications and presented with 95% confidence intervals and cost-effectiveness acceptability curves.Results: The MGT group had significantly lower healthcare and societal costs (mean differences -€115 (95% CI -193 to -36) and -€112 (95% CI -207 to -17), respectively) compared with the control group. In terms of effectiveness, there was no significant difference in QALY gain (mean difference -0.003, 95% CI -0.0076 to 0.0012) between the two groups.Conclusions: MGT is a cost-saving alternative to treatment as usual over the trial duration from both a healthcare and a societal perspective for patients with a diagnosis of depression, anxiety or stress and adjustment disorders in Sweden. [ABSTRACT FROM AUTHOR]

The study aimed to evaluate an integrated intensive cognitive behavioral therapy (CBT) group treatment for people with substance-related syndrome in outpatient care and to identify eventual gender differences. The study population consisted of 35 outpatients (18 male, 17 female) at a clinic in Western Sweden. The patients completed a four-month period of intensive group therapy and participated in the data collection at admission and discharge. The data were collected using the following inventories: Beck Depression and Anxiety Inventories, Rosenberg Self-Esteem Scale, Hopelessness Scale, and Trait Hope Scale. Results showed decreases in anxiety, depression and experience of hopelessness, and increases in self-esteem and hope. In females, the most dramatic improvement was measured for the anxiety and depression attributes, while in males the strongest effect was measured for hope and self-esteem. This study provides clinical evidence of the positive effects of integrated intensive CBT in outpatient care of people with substance-related syndrome. [ABSTRACT FROM AUTHOR]

Background: Refugees and asylum-seekers have an elevated risk of mental health issues, such as depression and posttraumatic stress. Qualitative outcome studies can contribute by offering insight into patients' experiences of what they find beneficial and how they undergo the process of recovery. This study aligns with the small body of qualitative research focusing on refugees' perspectives of psychotherapeutic treatment for PTSD. Objective: This study investigates and compares the treatment experiences of refugees with posttraumatic stress disorder (PTSD) in psychoanalytic group therapy (PAGT) and individual psychodynamic therapy (PDT) within an outpatient context in Sweden. Method: 10 former patients were interviewed using a semi-structured interview schedule. Data were analysed and interpreted according to the principles of grounded theory. Results: The findings reveal distinct categories for each treatment modality, being reborn for PDT and building a home for PAGT. Being reborn involved persistent intrapersonal change and lasting improvement in posttraumatic symptoms. Building a home involved a sense of belonging, support and temporary relief from posttraumatic symptoms. Participants from both treatment modalities underscored the significance of cultivating trust in therapeutic relationships. Conclusions: The study emphasises the necessity for tailored therapeutic approaches, contributing valuable insights to the limited research on effective mental health interventions for this population.

Background: Although mindfulness‐based group therapies (MGTs) for depressive, anxiety or stress and adjustment disorders are promising, there is a substantial lack of knowledge regarding the long‐term improvements after such therapies in these common psychiatric disorders. Methods: Two hundred and fifteen patients were randomized in a randomized clinical trial (RCT) (ClinicalTrials.gov ID: NCT01476371) conducted in 2012 at 16 primary healthcare centres in southern Sweden. The patients were randomized to MGT or treatment as usual (TAU) and completed four psychometric self‐rated scales after 8 weeks of treatment. Approximately 12 months after the completion of the 8‐week treatment, the same scales were repeated. Ordinal and generalized linear‐mixed models, adjusted for cluster effects, were used for the analysis. Results: For all four psychometric scales (MADRS‐S [Montgomery‐Åsberg Depression Rating Scale‐S], HADS‐D, HADS‐A [Hospital Anxiety and Depression Scale A and D] and PHQ‐9 [Patient Health Questionnaire‐9]) the scores at the 1‐year follow‐up were significantly improved (all P values <0.001) in both groups. Furthermore, there were no significant differences between the MGT and TAU in the psychometric scores at the 1‐year follow‐up. Conclusions: To the best of our knowledge, this is the first RCT comparing the long‐term improvements after MGT with TAU. Although it cannot be excluded that our findings are a result of the natural course of common psychiatric disorders or other factors, they suggest a long‐term positive improvement after both MGT and TAU. [ABSTRACT FROM AUTHOR]

This article investigates how treatment factors are described by different client groups and by treatment staff. The material consists of interviews with clients (n = 81) and treatment staff (n = 18). The analysis focuses on two central themes - the importance of the treatment group and of the treatment staff, along with how these descriptions relate to the concept of the therapeutic alliance. The descriptions differ in parts between the client groups and between clients and staff. Clients as well as staff highlight structural and qualitative aspects of cohesion, but general patterns of how these are expressed in the groups are hard to grasp. However, some exceptions appear; while the clients often relate recognition to own experience of substance abuse, the staff often refer to external aspects of recognition, such as gender and/or experience of parenting. The results indicate that the social preconditions of the group members can influence group cohesion. In the treatment, focus is initially on cohesion and later on making change possible. This might create a dilemma; the homogeneity that initially creates cohesion can also act as a restraint on change. This is described in the results in relation to gender homogeneous client groups in treatment. [ABSTRACT FROM AUTHOR]

In 2015, a total of 35,369 unaccompanied refugee minors (URMs) sought asylum in Sweden. In a previous study of 208 URMs, we found that 76% screened positive for PTSD. This study aimed to (1) evaluate the indicated prevention program Teaching Recovery Techniques (TRT) in a community setting and describe the program’s effects on symptoms of PTSD and depression in URMs; and (2) examine participants’ experiences of the program. The study included 10 groups. Methods for evaluation included the Children’s Revised Impact of Event Scale (CRIES-8) and the Montgomery-Åsberg Depression Rating Scale Self-report (MADRS-S) at baseline and at post-intervention. Qualitative interviews were conducted with 22 participating URMs to elicit their experiences. Pre- and post-measures were available for 46 participants. At baseline, 83% of the participants reported moderate or severe depression and 48% suicidal ideation or plans. Although more than half (62%) of the participants reported negative life events during the study period, both PTSD (CRIES-8) and depression (MADRS-S) symptoms decreased significantly after the intervention (p = 0.017, 95% CI − 5.55; − 0.58; and p < 0.001, 95% CI − 8.94; − 2.88, respectively). The qualitative content analysis resulted in six overall categories: social support, normalisation, valuable tools, comprehensibility, manageability, and meaningfulness when the youth described their experiences of the program, well reflecting TRT’s program theory. Overall, results indicate that TRT, delivered in a community setting, is a promising indicated preventive intervention for URMs with PTSD symptoms. This successful evaluation should be followed up with a controlled study. [ABSTRACT FROM AUTHOR]

Background Insomnia is a common health problem, and most people who seek help for insomnia consult primary care. In primary care, insomnia treatment typically consists of hypnotic drugs, although cognitive behavioral therapy for insomnia is the recommended treatment. However, such treatment is currently available to few primary care patients. Objectives To evaluate the effects of a group treatment program for insomnia led by nurses in primary care. Outcomes were the Insomnia Severity Index, a 2-week sleep diary, and a questionnaire on frequency of hypnotic drug use. Design A randomized controlled trial with pre- and post-treatment assessment and a 1-year post-treatment follow-up of the intervention group. Settings Routine primary health care; 7 primary care centers in Stockholm, Sweden. Participants Patients consulting primary care for insomnia were assessed for eligibility. To be included, patients had to have insomnia disorder and be 18 years or older. Patients were excluded if they if they worked night shifts or had severe untreated somatic and/or mental illness, bipolar disorder, or untreated sleep disorder other than insomnia. One-hundred and sixty-five patients 20 to 90 years were included. Most were women, and many had co-existing somatic and/or mental health problems. The post-treatment dropout rate was 20%. Methods The intervention was a nurse-led group treatment for insomnia based on the techniques of cognitive behavioral therapy for insomnia. The nurses had 2 days of training in how to deliver the program. Ninety patients were randomized to the intervention and 75 to the control group (treatment as usual). Data from 82 in the intervention and 71 in the control group were analyzed in accordance with intention-to-treat principles. Fifty-four of the 72 in the intervention group who participated in the group treatment program were followed up after 1 year. Results Mean Insomnia Severity Index score decreased significantly from 18.4 to 10.7 after group treatment but remained unchanged after treatment as usual (17.0 to 16.6). The effect size was large (1.23). Group treatment also resulted in significant improvements in all sleep diary variables (sleep onset latency, total sleep time, time awake after sleep onset, number of awakenings, and sleep quality). It also reduced hypnotic drug use. Improvements were maintained 1-year post-treatment. Conclusions Patients with insomnia can be treated successfully with a nurse-led group treatment program in primary health care. The results support implementation of the treatment program, particularly given the need for increased access to non-pharmacological insomnia treatments. [ABSTRACT FROM AUTHOR]

Despite substantial problems with intimate partner violence (IPV) worldwide, the empirical support remains weak for the effectiveness of recidivism-reducing interventions for IPV perpetrators. We conducted a controlled study of the effectiveness of the Integrated Domestic Abuse Program (IDAP), a manual-based group intervention for adult male IPV offenders. A consecutive series of 340 convicted male IPV offenders who began IDAP in the Swedish Prison and Probation Services 2004 to 2007 were compared with 452 contemporary, convicted male IPV offender controls. We obtained follow-up reconviction data from the National Crime Register and used Cox regression to model the effectiveness of IDAP versus regular treatment. Treated and control subjects were all followed until March 2, 2011, for an average time-at-risk of 4.6 years (median 4.4, SD = 1.0). Twenty-five percent (n = 84) of IDAP participants recidivated in any violence versus 23% of controls (n = 104); corresponding figures for IPV specifically were 19% (n = 65) and 19% (n = 84), respectively. Intention-to-treat analyses adjusted for individual baseline risk and follow-up time suggested marginally and non-significantly lower reconviction rates in IDAP participants versus controls (hazard ratio [HR] = 0.92, 95% confidence interval [CI] = [0.69, 1.23] for any violence and HR = 0.92, 95% CI = [0.66, 1.28] for IPV, respectively). Hence, possible recidivism-reducing effects of IDAP in this cross-cultural validation were small and impossible to secure statistically. To remedy the frustrating lack of proven effective treatments for IPV offenders, better interventions should be developed and tested. Such efforts could benefit from improved knowledge about IPV-specific, causal risk factors and more powerful treatment combinations. [ABSTRACT FROM AUTHOR]

Background Long-term stress leading to burnout symptoms is prevalent in parents of chronically ill children. The aim of the study was to evaluate the effect of a group intervention by measuring changes in self-rated clinical burnout and performance-based self-esteem. In addition, the parental perceptions of the acceptability of the intervention were explored. Methods Previously, we have explored the prevalence of clinical burnout in parents of patients 1-18 years with type 1 diabetes mellitus ( T1 DM) and inflammatory bowel disease ( IBD) in the county of Örebro. All parents who exhibited clinical burnout symptoms in accordance with the Shirom- Melamed Burnout Questionnaire ( SMBQ) were then invited to participate in a group intervention, which was evaluated in the present small-scale study. The group intervention consisted of eight sessions over a 12-week period, including education about behaviour, cognition and symptoms associated with burnout, intending to help the parents to develop adequate strategies for coping with and reducing stress. We evaluated the effect of the intervention in terms of self-rated clinical burnout and performance-based self-esteem ( PBSE). In addition, the acceptability of the intervention was evaluated by analyses of recruitment and retention and self-reports from parents. Results Sixteen parents (13 of children with TIDM and three of children with IBD) out of 104 reporting clinical burnout participated in the intervention. All participants completed the intervention, and the mean attendance rate at all sessions was 90%. Parents' subjective evaluations were mainly positive, and SMBQ (p = 0.01) and PBSE scale (p = 0.04) measurements were significantly reduced, which effects remained 6 months after completion of the intervention. Conclusions Despite the small-scale study, we consider that this intervention for parents with clinical burnout was appreciated and well accepted. The significant reduction in clinical burnout symptoms requires further evaluation in randomised controlled studies based on larger groups of parents. [ABSTRACT FROM AUTHOR]

Although adults with autism spectrum disorder are an increasingly identified patient population, few treatment options are available. This preliminary randomized controlled open trial with a parallel design developed two group interventions for adults with autism spectrum disorders and intelligence within the normal range: cognitive behavioural therapy and recreational activity. Both interventions comprised 36 weekly 3-h sessions led by two therapists in groups of 6–8 patients. A total of 68 psychiatric patients with autism spectrum disorders participated in the study. Outcome measures were Quality of Life Inventory, Sense of Coherence Scale, Rosenberg Self-Esteem Scale and an exploratory analysis on measures of psychiatric health. Participants in both treatment conditions reported an increased quality of life at post-treatment (d = 0.39, p < 0.001), with no difference between interventions. No amelioration of psychiatric symptoms was observed. The dropout rate was lower with cognitive behavioural therapy than with recreational activity, and participants in cognitive behavioural therapy rated themselves as more generally improved, as well as more improved regarding expression of needs and understanding of difficulties. Both interventions appear to be promising treatment options for adults with autism spectrum disorder. The interventions’ similar efficacy may be due to the common elements, structure and group setting. Cognitive behavioural therapy may be additionally beneficial in terms of increasing specific skills and minimizing dropout. [ABSTRACT FROM PUBLISHER]

Objective. To investigate whether interventions that have positive effects on psychological symptoms and quality of life compared with usual care would also reduce days on sick leave. Design. A randomized controlled trial. Setting. A large primary health care centre in Stockholm, Sweden. Intervention. Patients with common mental disorders were recruited by their GPs and randomized into one of two group interventions that took place in addition to usual care. These group interventions were: (a) group cognitive behavioural therapy (CBT), and (b) group multimodal intervention (MMI). Both types of intervention had previously shown significant effects on quality of life, and MMI had also shown significant effects on psychological symptoms. Patients. Of the 245 randomized patients, 164 were employed and had taken sick leave periods of at least two weeks in length during the study period of two years. They comprised the study group. Main outcome measures. The odds, compared with usual care, for being sick-listed at different times relative to the date of randomization. Results. The mean number of days on sick leave increased steadily in the two years before randomization and decreased in the two years afterwards, showing the same pattern for all three groups .The CBT and MMI interventions did not show the expected lower odds for sick-listing compared with usual care during the two-year follow-up. Conclusion. Reduction in psychological symptoms and increased well-being did not seem to be enough to reduce sickness absence for patients with common mental problems in primary care. The possibility of adding workplace-oriented interventions is discussed. [ABSTRACT FROM AUTHOR]

Stress-related disorders are a frequent cause for sick leave, with consequences such as great distress and adverse economic effects for the affected person and substantial costs for society. Identifying effective interventions that facilitate return to work is thus important. The aim of this study was to evaluate the effectiveness of the 16-week Redesigning Daily Occupations program as a work rehabilitation method for Swedish women with stress-related disorders. The authors of this study hypothesized that, compared to women who got Care as Usual, 12 months after completed rehabilitation a larger proportion of the Redesigning Daily Occupations women would have returned to work, and they would have less sick leave, perceive less stress, and have greater self-esteem. Forty-two women entered the Redesigning Daily Occupations intervention and a matched comparison group received Care as Usual. The data, collected between 2007 and 2010, consisted of registry information and questionnaires targeting socio-demographics, perceived stress, and self-esteem. The findings partly verified the hypotheses. A larger proportion of the Redesigning Daily Occupations women returned to work and they decreased their sick leave and increased their self-esteem more than the Care as Usual group, but the groups did not differ in stress reduction. Thus, the Redesigning Daily Occupations seems to be a promising work rehabilitation method for women with stress-related disorders. [ABSTRACT FROM PUBLISHER]

This study evaluated a community-based treatment program in Sweden for mothers subjected to intimate partner violence. Results based on group means indicated that the mothers showed significantly reduced trauma and psychological symptoms and improved sense of coherence after participating in the program. Surprisingly, no improvement regarding perceived parental locus of control was found. Furthermore, as a complement to group statistics a reliable change index was used, which resulted in more modest results regarding the effectiveness of the treatment. [ABSTRACT FROM AUTHOR]

Discusses the psychosomatic rehabilitation and treatment programs at the Institute of Psychosomatic Medicine in Sweden. Psychosomatic examination of patients; Individual and group psychotherapy; Evaluation of the programs.

Aims: Hypersensitivity to electricity ( HE ) is a common form of reported environmental illness in Sweden. Functional somatic symptoms has been attributed to exposure to activated electrical equipment, but no causal relationship to electromagnetic fields has been proved. In many cases, traumatic life events and psychosocial stress can be identified, but patients often reject psychological explanations. This study evaluates the effectiveness of a new short-term group-intervention programme. Methods: A multidisciplinary team developed a short-term group-intervention programme, with a salutogenic approach that focuses on somatic and psychological reactions. Twenty-two patients (14 women and 8 men) who reported HE participated in eight weekly sessions of group meetings and physiotherapy. The effect of the programme was evaluated with regard to changes in work capacity, subjective well-being, coping ability, body awareness and physical fitness. Results: Contrary to our hypothesis physical fitness was not remarkably low. Muscular tension was reduced and body awareness increased but no significant change in symptoms was observed. Individual differences in progress were observed. Fourteen patients chose to continue with psychotherapy or physiotherapy. Conclusions: Participants accepted the programme very well. One important result was identification of underlying contributing factors and motivation for further therapy. A multidisciplinary group-intervention programme with a salutogenic approach might be a useful approach to patients with medically unexplained symptoms in primary healthcare. [ABSTRACT FROM AUTHOR]

Work-related stress is an increasing health problem among nursing teachers, contributing to health problems, disengagement and poor job satisfaction. Negative coping strategies impact on both teachers' and students' teaching-learning experiences. Several interventions have been developed to address work-related stress. There has been less focus on how nursing teachers can learn to recover from work-related stress before it has severe consequences for their health, and to understand it from a nursing perspective. The aim of this study was to explore how nursing teachers who participated in a cognitive relational group programme experienced the process of recovery from work-related stress. Data were collected by means of three focus groups and subjected to qualitative content analysis, resulting in three categories: relatedness, evoking the inner caregiver, and re-orientation in life. These categories were reflected on in relation to Benner and Wrubel's "primacy of caring" and synthesised into a metaphorical theme: "finding one's footings". The findings imply that the development of positive coping strategies as well as knowledge and understanding about psychological processes are vehicles in the process of recovery. We conclude that interventions also need to account for the process of recovery as related to an ontological level and the person's Being-in-the-World. • For nursing teachers the work they love can be an unavoidable stressor. • Distancing oneself from what matters is not a desirable solution to reduce stress. • Recovery from work-related stress goes beyond learning coping strategies. • Recovery is associated with a sense of finding oneself and one's place in the world. • Interventions need to address work-related stress also on an ontological level. [ABSTRACT FROM AUTHOR]

Background: When death ends a life, the impact of caring for person who suffered a period of illness or disease continues for significant others who are left to grieve. They should be offered support to avoid complicated grief. This can be provided in different ways and individually or in groups. This study aims to describe significant others' experiences of participation in bereavement groups. Methods: Ten bereavement groups that each met five times offered support for the significant others of deceased loved ones who had been cared for by a palliative-care team. After the five meetings, the grieving members (n = 46) completed written comments about the role of the groups; they also commented one year after participating (n = 39). Comments were analyzed with qualitative content analysis with a directed approach using the theory of a good death according to the 6S's: self-image, self-determination, social relationships, symptom control, synthesis and summation, and surrender. Results: Bereavement groups were found to be a source for alleviating grief for some significant others, but not all experienced relief. Moreover, grief was found to persist during participation. Another finding involved the impact of the role of the palliative home-care team on bereavement support. To evaluate the experience of participating in a bereavement group, the use the 6S's as a model was a strength of the analysis. Bereavement groups could enhance the self and offer relief from grief. Participation was described as social relationships that offered a sense of coherence and understanding in grief. The effects of participation were more meaningful close to the loss and could lose efficacy over time. Bereavement support provided before a loved one's death was seen as valuable. Conclusion: Overall, the bereavement groups eased the grief of significant others close to the death of their loved one. However, moving forward, several of the significant others were not sure that their participation eased their grief. To identify persons who may remain in a state of complicated grief, a routine of planned contacts with the bereaved should begin before death and be followed up later than six months after the death of a loved one. [ABSTRACT FROM AUTHOR]

The schemes in the UK, France and Sweden are the Early Access to Medicines Schemes (EAMS), cohort Temporary Authorization for Use (cohort-ATU) and Compassionate Use Program (CUP), respectively. Their main distinction relates to reimbursement: the cohort-ATU allows manufacturers to charge whereas under EAMS and CUP the manufacturer must provide for no charge. Conclusions The EAMS, CUP and cohort-ATU schemes appear to attract a largely distinct group of therapies and the cohort-ATU scheme has attracted over double and triple the drug:indication pairings than EAMS and CUP respectively. [Extracted from the article]