Högskolan i Skövde

The coexistence of mental and physical health illnesses could be accounted for by an underlying general disease factor (termed d-factor), reflecting theoretical underpinnings based on possible genetic and pathophysiological overlapping mechanisms. This study evaluated whether the d-factor underlies mental and physical health illnesses in adolescents. A series of confirmatory factor analyses were conducted using data from 1120 adolescents. The proposed common underlying factor, we believe is the d-factor, was consistently present across different modeling approaches, including unidimensional, correlated-factor, and bifactor models. The best model fit was achieved with the bifactor model represented by mental, neurological, and psychical conditions tested. The first compelling evidence was provided supporting the existence of the transdiagnostic d-factor in youth, opening the door to innovative research of comorbid mental and physical health conditions.

Background: Multiple studies have shown that healthcare professionals often feel uncertain about when to inquire about intimate partner violence (IPV), the appropriate methods for doing so, and how to respond to the answers. Virtual patient (VP) cases are an interactive educational tool that can be effective for learning and training clinical reasoning skills. However, there is a lack of research on the use of VP in psychiatry education. This study aimed to investigate nursing students' experiences of using a VP as part of an educational module, integrated into their foundational training on IPV during their nursing education.

Methods: The study employed a mixed-methods approach, incorporating both quantitative and qualitative data. Participants (N = 62) completed an interactive educational module on IPV, in three consecutive parts: (a) a web-based education on IPV, (b) training with a VP, and (c) a seminar for follow-up discussions.

Results: The VP platform was considered user-friendly and easy to navigate, although some participants found the instructions challenging. Participants perceived the VP as beneficial for learning about IPV and for practicing interactive patient dialogues. They appreciated the rich set of questions and the feedback provided, both by the experts in the field of IVP and by the VP itself. However, some participants noted that interacting with a VP on a screen was less emotional compared to real human interactions.

Conclusion: The interactive educational module, integrated into the regular nursing program, was positively received by the students. Overall, the VP was considered beneficial for learning about IPV, easy to navigate, and provided a valuable opportunity for practice.

BACKGROUND: Collegial conversations are important for sustainable learning to last beyond a course. Research on collegial conversations and peer learning in the workplace during psychiatric residency courses remains sparse, however. In this study, the aim was to explore residents' opportunities for collegial conversations during and after national courses in psychiatry.

METHODS: Residents in psychiatry completed an online survey including questions on opportunities for collegial conversations in their workplaces. Logistic regression was used for multivariate analysis and thematic content analysis was used for the open-ended answers where a theoretical framework of communities of practice was employed for the interpretation of the findings.

RESULTS: The survey was completed by 112 residents out of 725 (15,4%). The participants reported few structured forums for collegial discussion. The results of multivariate analysis suggest that more women than men feel it is advantageous to attend courses with others from the same workplace or from the same group of residents, described here as a team. The analysis of qualitative data identified how opportunities for collegial conversations differ across contexts and the type of values that are attached to team participation in residency courses.

CONCLUSIONS: This study highlights the importance of collegial conversations as a way to sustain the learning from residency courses into the workplace. By learning about residents' perceptions of collegial conversations during and after courses, teachers and directors may be more able to support residents' lifelong learning and professional development.

Climate change is a serious contemporary issue around the world. Adolescents are mostly affected due to climate change. Thus, they are expected to behave in an environmentally appropriate manner, which requires the identification of factors influencing pro-sustainable behavior/pro-environmental behavior. The literature offers a wide range of factors influencing adolescents’ pro-sustainable behavior; nonetheless, these factors are not provided with some common themes. Furthermore, no study integrates dispersed research of the area with a comprehensive systematic review. With this consideration, a systematic review was carried out to find comprehensive factors influencing the pro-sustainable behavior of adolescents. For the review, all 21 interdisciplinary studies on factors influencing adolescents' ecological behavior, published between 2010 and 2023 and indexed in Scopus and Web of Science, were analyzed. The analysis revealed that the number of studies in the area increased after 2020, especially in developed countries, and most studies utilized quantitative research methods. The identified key factors influencing adolescents’ pro-environmental behavior are categorized into demographic, internal, and external factors. The findings can be helpful for future researchers to have rigorous discourse on the issue and expand the research in developing countries using mixed methods research. The policy maker can use findings to motivate adolescents to participate in climate change mitigation.

BackgroundPredictive eHealth tools will change the field of medicine, however long-term data is scarce. Here, we report findings on data collected over 6 years with an AI-based eHealth system for supporting the treatment of alcohol use disorder.MethodsSince the deployment of Previct Alcohol, structured data has been archived in a data warehouse, currently comprising 505,641 patient days. The frequencies of relapse and caregiver-patient messaging over time was studied. The effects of both introducing an AI-driven relapse prediction tool and the COVID-19 pandemic were analyzed.ResultsThe relapse frequency per patient day among Previct Alcohol users was 0.28 in 2016, 0.22 in 2020 and 0.25 in 2022 with no drastic change during COVID-19. When a relapse was predicted, the actual occurrence of relapse in the days immediately after was found to be above average. Additionally, there was a noticeable increase in caregiver interactions following these predictions. When caregivers were not informed of these predictions, the risk of relapse was found to be higher compared to when the prediction tool was actively being used. The prediction tool decreased the relapse risk by 9% for relapses that were of short duration and by 18% for relapses that lasted more than 3 days.ConclusionsThe eHealth system Previct Alcohol allows for high resolution measurements, enabling precise identifications of relapse patterns and follow up on individual and population-based alcohol use disorder treatment. eHealth relapse prediction aids the caregiver to act timely, which reduces, delays, and shortens relapses.

Over the past two decades, it has become clear that psychopathology exists on continuous spectra organized hierarchically from broad, general symptom dimensions to more specific ones. This structure is best represented by the Hierarchical Taxonomy of Psychopathology (HiTOP) framework that incorporates individual signs, symptoms, and behaviors at its most specific level while encompassing higher-order dimensions at its broadest level. This commentary gives an overview of studies that evaluated higher-order dimensions of psychopathology and their alignment with the HiTOP framework. Studies consistently support the alignment of youth psychopathology with the HiTOP framework, particularly its general dimension of psychopathology and the broad internalizing and externalizing spectrum. The model also identifies distinct, lower-level dimensions such as fear, affectivity, antagonism, and attention problems. This hierarchical structure is evident across the entire age span but with specific makeup of dimensions appearing to differ between children and adolescents. Rapidly gaining momentum, current evidence indicates HiTOP’s effectiveness in conceptualizing youth mental health. Future studies should focus on exploring the HiTOP structure across different ages and populations, testing its real-world generalizability, selecting the most appropriate assessment tools, and understanding how the framework applies to youth from diverse societies and cultures. 

Background: Globally, the digital sources developed and available in antenatal care differ, and infrastructure challenges may impede the further development of such sources. Challenges accompanying digital developments can include the commonly occurring high workload, which affects healthcare professionals' ability to acquire professional knowledge about how to best support parents in using digital sources. Including healthcare professionals in the development process of digital sources may increase the likelihood that such sources will be adopted and employed by these professionals in their future care work. Therefore, the present research explored healthcare professionals' perceptions of the digital support intervention Childbirth Journey, which was constructed as a serious game for expectant parents.

Methods: Data were collected through semi-structured focus-group interviews with 11 midwives at antenatal, labour and postnatal clinics as well as with child healthcare nurses. Prior to the interviews, all participants were provided the intervention, Childbirth Journey, which is a serious game in a mobile application format consisting of two distinct parts: (1) a story-driven game and (2) a Knowledge Portal. The data were analysed using phenomenographic methods.

Results: The perceptions of Childbirth Journey by healthcare professionals, midwives and child healthcare nurses are presented in four descriptive categories: extended professional support, trustworthy contents, diversity or individuality, and both appealing and in need of development.

Conclusions: Current study revealed that Childbirth Journey may be utilised as a digital support for parents, allowing healthcare professionals to offer a digital solution as a complementary support to standard, face-to-face meetings with caregivers. However, the research results also revealed that some elements of Childbirth Journey must be improved, thereby representing a main contribution of this study: insights into how to better develop digital tools under the umbrella of health care. Thus, we conclude that in order to create sustainable and safe digital care solutions that function as trustworthy professional supports instead of technical products that risk harming users, the perspectives of both patients and healthcare professionals should be considered in the exploration and development of these solutions.

Objective: The aim of this study was to explore expecting parents’ perceptions of the Childbirth Journey as an intervention that includes medical information for parental support, constructed as a serious game.

Methods: In this qualitative study, semi-structured interviews were held with expecting parents in Sweden who were able to talk about specific parts of the Childbirth Journey they appreciated or found difficult to understand. A phenomenographic methodology was employed for data analysis.

Results: Participants perceived the Childbirth Journey to be easily accessible and customized with reliable information. The design and features of the intervention were perceived by the expecting parents to enhance the intervention’s usability, appeal, and trustworthiness. When parental couples used the Childbirth Journey together, it gave them an opportunity to discuss and better understand each other’s situation. The participants proposed several changes to the existing version of the game, mostly related to extending practical information and illustrated scenarios but also to the further development of the game’s design and animations. The participants found the Knowledge portal to be the most appealing part of the Childbirth Journey.

Conclusions: The Childbirth Journey intervention was concluded to be a valuable digital complement to in-person profes- sional support, especially given the current COVID-19 pandemic restrictions in place in Sweden, which do not allow antenatal visits by partners. However, in its current form, the Childbirth Journey has some deficiencies and would therefore benefit from further development and exploration.

Objective: To explore parents’ experiences using digital tools in relation to pregnancy, labor and birth, and the child’s first 18 months. Background: Parents find relevant information using digital healthcare tools, material obtained from professionals, as well as personal opinions and experiences that vary in quality. Method: Fifteen parents were interviewed and data were analyzed beginning with content analysis and followed by thematic analysis. Results: The main theme was insecurity and responsibility for own choices and knowledge. Parents use digital tools to take responsibility for their insecurity and need for knowledge when entering parenthood. Conclusion: The parents’ experiences highlighted that (1) insecurity can be both eased and enhanced using digital tools, (2) they took responsibility for feelings of insecurity and the search for knowledge, and (3) they needed knowledge to make the right choices and feel secure that these choices are made in the best interest of their new family. 

Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCE) is an umbrella term covering a wide range of neurodevelopmental difficulties and disorders. Thus, ESSENCE includes attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and other neurodevelopmental disorders (NDDs) and difficulties, with a variety of symptoms in cognitive, motor, sensory, social, arousal, regulatory, emotional, and behavioral developmental domains, frequently co-occurring and likely having partly common neurobiological substrates. The ESSENCE concept is a clinical paradigm that promotes organizing NDDs in everyday clinical practice according to their coexistence, symptom dimensions overlapping, and treatment possibilities. Despite increased knowledge regarding NDDs, the neurobiological mechanisms that underlie them and other ESSENCE-related problems, are not well understood. With its wide range of neural circuits and interactions with numerous neurotransmitters, the orexin/hypocretin system (Orx-S) is possibly associated with a variety of neurocognitive, psychobiological, neuroendocrine, and physiological functions and behaviors. Dysfunction of Orx-S has been implicated in various psychiatric and neurological disorders. This article provides an overview of Orx-S dysfunctions' possible involvement in the development, presentation, and maintenance of ESSENCE. We provide a focused review of current research evidence linking orexin neuropeptides with specific clinical NDDs symptoms, mostly in ADHD and ASD, within the Research Domain Criteria (RDoC) framework. We propose that Orx-S dysfunction might have an important role in some of these neurodevelopmental symptom domains, such as arousal, wakefulness, sleep, motor and sensory processing, mood and emotional regulation, fear processing, reward, feeding, attention, executive functions, and sociability. Our perspective is presented from a clinical point of view. Further, more thorough systematic reviews are needed as well as planning of extensive new research into the Orx-S’s role in ESSENCE, especially considering RDoC elements.