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Svensson, Tommy
Publications (10 of 57) Show all publications
Svensson, T., Gottzén, L. & Lögdlund, U. (2014). Introduktion. In: Lucas Gottzén och Ulrik Lögdlund (Ed.), Sociologins teoretiker: (pp. 13-21). Malmö: Gleerups Utbildning AB
Open this publication in new window or tab >>Introduktion
2014 (Swedish)In: Sociologins teoretiker / [ed] Lucas Gottzén och Ulrik Lögdlund, Malmö: Gleerups Utbildning AB, 2014, p. 13-21Chapter in book (Other academic)
Place, publisher, year, edition, pages
Malmö: Gleerups Utbildning AB, 2014
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Identifiers
urn:nbn:se:liu:diva-109667 (URN)9789140678638 (ISBN)
Available from: 2014-08-22 Created: 2014-08-22 Last updated: 2014-09-24Bibliographically approved
Vilhelmsson, A., Svensson, T. & Meeuwisse, A. (2013). A Pill for the Ill? Patients’ Reports of Their Experience of the Medical Encounter in the Treatment of Depression. PLoS ONE, 8(6)
Open this publication in new window or tab >>A Pill for the Ill? Patients’ Reports of Their Experience of the Medical Encounter in the Treatment of Depression
2013 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, no 6Article in journal (Refereed) Published
Abstract [en]

Background

Starting in the 1960s, a broad-based patients’ rights movement began to question doctors’ paternalism and to demand disclosure of medical information, informed consent, and active participation by the individual in personal health care. According to scholars, these changes contributed to downplay the biomedical approach in favor of a more patient-oriented perspective. The Swedish non-profit organization Consumer Association for Medicines and Health (KILEN) has offered the possibility for consumers to report their perceptions and experiences from their use of medicines in order to strengthen consumer rights within the health care sector.

Methodology

In this paper, qualitative content analysis was used to analyze 181 KILEN consumer reports of adverse events from antidepressant medications in order to explore patients’ views of mental ill health symptoms and the doctor-patient interaction.

Principal Findings

Overall, the KILEN stories contained negative experiences of the patients’ medical encounters. Some reports indicated intense emotional outrage and strong feelings of abuse by the health care system. Many reports suggested that doctors and patients had very different accounts of the nature of the problems for which the patient was seeking help. Although patients sought help for problems like tiredness and sleeplessness (often with a personal crisis of some sort as a described cause), the treating doctor in most cases was exceptionally quick in both diagnosing depression and prescribing antidepressant treatment. When patients felt they were not being listened to, trust in the doctor was compromised. This was evident in the cases when the doctor tried to convince them to take part in medical treatment, sometimes by threatening to withdraw their sick-listing.

Conclusions

Overall, this study suggests that the dynamics happening in the medical encounter may still be highly affected by a medical dominance, instead of a patient-oriented perspective. This may contribute to a questionable medicalization and/or pharmaceuticalization of depression.

Place, publisher, year, edition, pages
Public Library of Science, 2013
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-95965 (URN)10.1371/journal.pone.0066338 (DOI)000320576400087 ()
Note

Funding Agencies|Stiftelsen Kempe-Carlgrenska Fonden||Lundgrenska Fonden||Stiftelsen Sigurd och Elsa Goljes Minne||Stiftelsen Lars Hiertas Minne||Elsa Lundberg och Greta Flerons||studier av lakemedelsbiverkan||

Available from: 2013-08-19 Created: 2013-08-12 Last updated: 2017-12-06
Andersen, A. J. & Svensson, T. (2013). Internet-based Mental Health Services in Norway and Sweden: Characteristics and Consequences. Administration and Policy in Mental Health, 40(2), 145-153
Open this publication in new window or tab >>Internet-based Mental Health Services in Norway and Sweden: Characteristics and Consequences
2013 (English)In: Administration and Policy in Mental Health, ISSN 0894-587X, E-ISSN 1573-3289, Vol. 40, no 2, p. 145-153Article in journal (Refereed) Published
Abstract [en]

Internet-based mental health services increase rapidly. However, national surveys are incomplete and the consequences for such services are poorly discussed. This study describes characteristics of 60 Internet-based mental health services in Norway and Sweden and discusses their social consequences. More than half of the services were offered by voluntary organisations and targeted towards young people. Professionals answered service users questions in 60% of the services. Eight major themes were identified. These characteristics may indicate a shift in the delivery of mental health services in both countries, and imply changes in the understanding of mental health.

Place, publisher, year, edition, pages
Springer Verlag (Germany), 2013
Keywords
Internet-based services, Mental health, E-mail, Voluntary organisations, Governmentality
National Category
Engineering and Technology
Identifiers
urn:nbn:se:liu:diva-89801 (URN)10.1007/s10488-011-0388-2 (DOI)000314706800010 ()
Available from: 2013-03-07 Created: 2013-03-07 Last updated: 2017-12-06
Hillborg, H., Danermark, B. & Svensson, T. (2013). Professionals perceptions of and views about vocational rehabilitation for people with psychiatric disabilities. Work: A journal of Prevention, Assesment and rehabilitation, 44(4), 471-480
Open this publication in new window or tab >>Professionals perceptions of and views about vocational rehabilitation for people with psychiatric disabilities
2013 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 44, no 4, p. 471-480Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: One of the challenges agencies and professionals face is to enable people on sick leave to be successful in their vocational rehabilitation. The objective of this study was to explore and analyze some professionals perceptions of and views about vocational rehabilitation among people with psychiatric disabilities. less thanbrgreater than less thanbrgreater thanPARTICIPANTS: Eight professionals from four different agencies (social services, the employment service, the social insurance office, and a psychiatric outpatient setting) working in the area of vocational rehabilitation for people with psychiatric disabilities. less thanbrgreater than less thanbrgreater thanMETHODS: Eight in-depth interviews were conducted. The data collected was analyzed using qualitative content analysis together with an interpretive approach. less thanbrgreater than less thanbrgreater thanRESULTS: The results suggested the respondents were in consensus regarding that which they considered to facilitate or enable successful vocational rehabilitation. Intensive support over a long period of time and a holistic view that takes into account the habits and routines of daily life outside of work as well as the social and psychological aspects of individuals during their rehabilitation processes were considered to be just as crucial to the vocational rehabilitation process as training in the workplace. less thanbrgreater than less thanbrgreater thanCONCLUSIONS: These professionals dealt with a complex vocational rehabilitation system; they felt that their organizations directives and inability to collaborate successfully with other authorities restricted their scope of action and hindered their exercise of good practice.

Place, publisher, year, edition, pages
IOS Press, 2013
Keywords
Mental illness, interagency collaboration, vocational rehabilitation, supported employment
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-91945 (URN)10.3233/WOR-131518 (DOI)000316852800010 ()
Available from: 2013-05-06 Created: 2013-05-06 Last updated: 2017-12-06
Vilhelmsson, A., Svensson, T., Meeuwisse, A. & Carlsten, A. (2012). Experiences from consumer reports on psychiatric adverse drug reactions with antidepressant medication: a qualitative study of reports to a consumer association. BMC Pharmacology, 13
Open this publication in new window or tab >>Experiences from consumer reports on psychiatric adverse drug reactions with antidepressant medication: a qualitative study of reports to a consumer association
2012 (English)In: BMC Pharmacology, ISSN 1471-2210, Vol. 13Article in journal (Refereed) Published
Abstract [en]

Background

The new European pharmacovigilance legislation has been suggested as marking the beginning of a new chapter in drug safety, making patients an important part of pharmacovigilance. In Sweden since 2008 it has been possible for consumers to report adverse drug reactions (ADRs) to the Medical Products Agency (MPA), and these reports are now understood as an increasingly valuable contribution in the monitoring of safety aspects in medicines. Already in 2002 it was possible to report experiences with medicines to the non-profit and independent organization Consumer Association for Medicines and Health (KILEN) through a web-based report form with an opportunity to describe ADR experiences in free text comments. The aim of this study was to qualitatively analyze the free text comments appended to consumer reports on antidepressant medication.

Methods

All reports of suspected adverse reactions regarding antidepressant medications submitted from January 2002 to April 2009 to KILEN’s Internet-based reporting system in Sweden were analyzed according to reported narrative experience(s). Content analysis was used to interpret the content of 181 reports with free text comments.

Results

Three main categories emerged from the analyzed data material: (1) Experiences of drug treatment with subcategories (a) Severe psychiatric adverse reactions, and (b) Discontinuation symptoms; (2) Lack of communication and (3) Trust and distrust. A majority of the reports to KILEN were from patients experiencing symptoms of mental disturbances (sometimes severe) affecting them in many different ways, especially during discontinuation. Several report included narratives of patients not receiving information of potential ADRs from their doctor, but also that there were no follow-ups of the treatment. Trust was highlighted as especially important and some patients reported losing confidence in their doctor when they were not believed about the suspected ADRs they experienced, making them attempt to discontinue their antidepressant treatment on their own.

Conclusions

The present study indicates that free text comments as often contained in case reports directly submitted by patients can be of value in pharmacovigilance and provide important information on how a drug may affect the person using it and influence his or her personal life.

Place, publisher, year, edition, pages
BioMed Central, 2012
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-95514 (URN)10.1186/2050-6511-13-19 (DOI)000319691800001 ()
Note

Funding Agencies|Stiftelsen Kempe-Carlgrenska Fonden||Folksams Forskningsstiftelse||Stiftelsen Claes Groschinskys Minnesfond||Stiftelsen Lars Hiertas Minne||Elsa Lundberg och Greta Flerons fond for studier av lakemedelsbiverkan||

Available from: 2013-07-05 Created: 2013-07-05 Last updated: 2017-12-06
Ståhl, C., Müssener, U. & Svensson, T. (2012). Implementation of standardized time limits in sickness insurance and return-to-work: Experiences of four actors. Disability and Rehabilitation, 34(16), 1404-1411
Open this publication in new window or tab >>Implementation of standardized time limits in sickness insurance and return-to-work: Experiences of four actors
2012 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 16, p. 1404-1411Article in journal (Refereed) Published
Abstract [en]

Purpose: In 2008, time limits were introduced in Swedish sickness insurance, comprising a pre-defined schedule for return-to-work. The purpose of this study was to explore experienced consequences of these time limits. Sick-listed persons, physicians, insurance officials and employers were interviewed regarding the process of sick-listing, rehabilitation and return-to-work in relation to the reform.

Method: The study comprises qualitative interviews with 11 sick-listed persons, 4 insurance officials, 5 employers and 4 physicians (n = 24). Results: Physicians, employers, and sick-listed persons described insurance officials as increasingly passive, and that responsibility for the process was placed on the sick-listed. Several ethical dilemmas were identified, where officials were forced to act against their ethical principles. Insurance officials' principle of care often clashed with the standardization of the process, that is based on principles of egalitarianism and equal treatment.

Conclusions: The cases reported in this study suggest that a policy for activation and early return-to-work in some cases has had the opposite effect: central actors remain passive and the responsibility is placed on the sick-listed, who lacks the strength and knowledge to understand and navigate through the system. The standardized insurance system here promoted experiences of procedural injustice, for both officials and sick-listed persons.

Place, publisher, year, edition, pages
Informa Healthcare, 2012
Keywords
Work disability, return-to-work, ethics, Sweden
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-73393 (URN)10.3109/09638288.2011.641667 (DOI)000305421700008 ()22200168 (PubMedID)
Available from: 2012-01-02 Created: 2012-01-02 Last updated: 2017-12-08Bibliographically approved
Wenemark, M., Persson, A., Noorlind Brage, H., Svensson, T. & Kristenson, M. (2011). Applying Motivation Theory to Achieve Increased Respondent Satisfaction, Response Rate and Data Quality in a Self-administered Survey. Journal of Official Statistics, 27(2), 393-414
Open this publication in new window or tab >>Applying Motivation Theory to Achieve Increased Respondent Satisfaction, Response Rate and Data Quality in a Self-administered Survey
Show others...
2011 (English)In: Journal of Official Statistics, ISSN 0282-423X, E-ISSN 2001-7367, Vol. 27, no 2, p. 393-414Article in journal (Refereed) Published
Abstract [en]

Response rates to surveys are declining in most countries. Attempts to persuade or pressure respondents to increase response might be counterproductive in the long-term because they can negatively affect attitudes towards future surveys. Targeting respondents’ own motivation to participate in surveys is an alternative approach to achieve higher response rates. Self-determination theory provides a theoretical framework for how intrinsic motivation can be stimulated. We used self-determination theory as inspiration to re-design a self-administered health-related survey. Two versions of the questionnaire and two data collection methods were used in an experimental design. Effects were measured in terms of respondent satisfaction, response rate, and data quality. The results suggest that it is possible to improve response rates in a way that also promotes data quality and positive experiences for the respondents.

Place, publisher, year, edition, pages
Almqvist & Wiksell International / Statistics Sweden, 2011
Keywords
Survey design; respondent motivation; self-determination theory; intrinsic motivation; questionnaire
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-60182 (URN)000292708100013 ()
Available from: 2010-10-07 Created: 2010-10-07 Last updated: 2017-12-12
Ståhl, C., Svensson, T. & Ekberg, K. (2011). From Cooperation to Conflict? Swedish Rehabilitation Professionals' Experiences of Interorganizational Cooperation.. Journal of occupational rehabilitation, 21(3), 441-448
Open this publication in new window or tab >>From Cooperation to Conflict? Swedish Rehabilitation Professionals' Experiences of Interorganizational Cooperation.
2011 (English)In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 21, no 3, p. 441-448Article in journal (Refereed) Published
Abstract [en]

Purpose This article analyses Swedish rehabilitation professionals' experiences of interorganizational cooperation in return-to-work and labour market reintegration.

Method Two groups (n = 15) from different organizations met on a regular basis to discuss their practice from a cooperation perspective. The participants had experience of cooperation in the organizational setting of Coordination Associations. The groups worked with a tutor according to a problem-based methodology, to discuss how their practice is influenced by new structures for cooperation. The material was analysed inductively using qualitative content analysis.

Results Interorganizational cooperation in rehabilitation is generally perceived as promoting coherence and communication. Nevertheless, there are several contradictory factors in the implementation of such work forms, primarily inflexible sickness insurance regulations and inability of managers to implement cooperation in regular practice.

Conclusions While interorganizational cooperation promotes professional discretion and tailored solutions, the insurance system contradicts such ambitions through increased governance. Ultimately, the contradictory tendencies of cooperative initiatives and the stricter governance of sickness insurance regulations are political matters. If political attempts to promote interorganizational cooperation are to succeed, the increasing sectorization that results from strict governance of sickness insurance regulations needs to be targeted on a system level.

Place, publisher, year, edition, pages
Springer, 2011
Keywords
Cooperation, Return to work, Labour market reintegration, policy
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-66499 (URN)10.1007/s10926-010-9281-1 (DOI)000297174100015 ()21274740 (PubMedID)
Available from: 2011-03-18 Created: 2011-03-18 Last updated: 2017-12-11Bibliographically approved
Vilhelmsson, A., Svensson, T. & Meeuwisse, A. (2011). Mental Ill Health, Public Health and Medicalization. Public Health Ethics, 4(3), 207-217
Open this publication in new window or tab >>Mental Ill Health, Public Health and Medicalization
2011 (English)In: Public Health Ethics, ISSN 1754-9973, E-ISSN 1754-9981, Vol. 4, no 3, p. 207-217Article in journal (Refereed) Published
Abstract [en]

WHO suggests mental ill health in terms of depression to be the highest ranking disease problem in the developed world in 2020-2030 and claims a public health approach to be the most appropriate response. But some argue that the alarming reports on mental ill health have their ground in the methods of inquiry themselves and refer to medicalization as an important issue. The aim of this article is to explore and illuminate the issue of what is meant by mental health and mental ill health and what it means that mental ill health is a major public health problem. Basically, two understandings and aspects of public health exist: a reductionist and a holistic with connections to different theories of health. These diverging understandings may lead to quite different public health responses, and they may have different consequences with regard to medicalization. It is concluded that we need more clearly elaborated ways to think about public health so that the increased attention to mental ill health as a public health problem does not in itself lead to medicalization in terms of just medical treatment. Otherwise, we risk losing the importance of public health as an overarching social and political instrument.

Place, publisher, year, edition, pages
Oxford University Press (OUP): Policy F, 2011
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-75742 (URN)10.1093/phe/phr030 (DOI)000300219400001 ()
Available from: 2012-03-09 Created: 2012-03-09 Last updated: 2017-12-07
Ståhl, C., Müssener, U. & Svensson, T. (2011). Sjukskrivningssystemet och dess aktörer: Efter införandet av rehabiliteringskedjan. Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Sjukskrivningssystemet och dess aktörer: Efter införandet av rehabiliteringskedjan
2011 (Swedish)Report (Other academic)
Abstract [sv]

Sedan 2008 har ett antal större förändringar gjorts i sjukförsäkringen. Främst har rehabiliteringskedjan, dvs. införandet av fasta tidsgränser för bedömning av arbetsförmåga och rätt till ersättning, stått i fokus för debatten. Med tidsgränserna sattes en slutgräns för hur länge sjukpenning betalas ut, vilket tidigare inte fanns i försäkringen. I denna studie undersöks hur sjukskrivna, arbetsgivare, försäkringskassehandläggare och läkare resonerar kring dessa tidsgränser, arbetsförmågebedömningar, rehabilitering och återgång i arbete.

Studien omfattar kvalitativa intervjuer med sjukskrivna, arbetsgivare, handläggare på Försäkringskassan samt primärvårds- och företagsläkare. Totalt intervjuades 24 personer.

Sjukskrivna, arbetsgivare och läkare upplever att Försäkringskassans handläggare blivit mindre tillgängliga, och generellt uppfattas handläggarna som alltmer passiva i rehabiliteringsprocessen. Handläggare på Försäkringskassan menar att de senaste årens regeländringar har medfört en mer administrativ handläggarroll, där mer tid läggs på att hålla tidsgränser än att arbeta med faktisk rehabilitering. Handläggare upplever också att etiska dilemman uppstår när individuella bedömningar kommer i konflikt med tidsgränserna, vilket upplevs som stressande.

De sjukskrivna upplever att Försäkringskassan borde ta ett större ansvar för att driva sjukskrivnings- och rehabiliteringsprocessen framåt, eftersom de själva har svårt att överblicka och navigera i sjukförsäkringssystemet. Även arbetsgivarna i studien förväntar sig att Försäkringskassan ska ta större ansvar för sjukskrivningsprocessen. Handläggarna på Försäkringskassan har å sin sida blivit alltmer benägna att lägga detta ansvar på de sjukskrivna.

Studien identifierar också flera brister i samverkan mellan arbetsgivare, sjukvård och Försäkringskassan kring bedömningen av sjukskrivnas arbetsförmåga. Försäkringskassans handläggare lägger stor vikt vid de medicinska underlagen i bedömningarna, och ger uttryck för en tveksamhet inför att använda andra informationskällor (såsom SASSAMkartläggningar), då det upplevs som avsteg från rådande riktlinjer.

Ett av syftena med rehabiliteringskedjan var att skapa en mer enhetlig och standardiserad sjukskrivningsprocess. Dock upplever såväl handläggare som sjukskrivna att systemet är oflexibelt och inte tar hänsyn till individers olikheter och skilda behov, och att de fasta tidsgränserna därmed medfört en ökad orättvisa för de sjukskrivna. Även om bemötandet från handläggare på Försäkringskassan i många fall upplevs som bra, uppfattas sjukförsäkringssystemet som orättvist; studien ger därmed i första hand exempel på upplevd proceduriell orättvisa, snarare än upplevelser av orättvist bemötande.

Studien visar på ett ytterligare behov av att studera etik, rättvisa och kvalitet i sjukskrivningsprocessen. 

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2011. p. 49
Series
HELIX working papers, ISSN 1654-8213 ; 7
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-72618 (URN)
Available from: 2011-11-30 Created: 2011-11-30 Last updated: 2015-06-02Bibliographically approved
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