How children in Sweden accessed and perceived information during the first phase of the Covid-19 pandemic

AIM

To describe how children in Sweden accessed and perceived information about SARS-CoV2 and Covid-19 during the first phase of the outbreak.

METHODS

This study is a substudy of an international cross-sectional online mixed methods survey examining elements of children's health literacy in relation to Covid-19. The survey included multiple-choice questions, open-ended questions and drawings and collected information from 50 Swedish children (7-12 years). Data were analysed concurrently on a descriptive level using statistics and content analysis. Quantitative and qualitative data, including the drawings, were considered equally important and resulted in six categories, illuminating how children accessed and perceived information about the pandemic.

RESULTS

The survey showed that children accessed information mainly from school but also from TV. They preferred information from reliable sources. Children reported the information they accessed as easy to understand and it prompted them to ask new questions. They reported they knew a lot about the pandemic, for example, the potential danger to themselves and others and how to act to protect themselves and others. They perceived the pandemic as an intrusion on their lives.

CONCLUSIONS

This study indicates that Swedish children between 7 and 12 years old were well informed about SARS-CoV2 and Covid-19 during the first phase of the pandemic. School was shown to be an important source of information. The children could explain how to act to protect themselves and others from becoming infected by the virus.

Caught on the Fringes of Life: Mothers' Lived Experiences of Initial Breastfeeding Complications

Becoming a parent changes one's life, and existential questions arise. Time and being oscillate between joy and powerlessness, vulnerability, and self-confidence, between harmony and unpreparedness. Breastfeeding, one of the first skills new mothers try to master, can be joyful and painful. The aim of this study was to develop a deeper understanding of the phenomenon of initial breastfeeding complications as they are lived and experienced by mothers and how these mothers can be supported. Twelve mothers were interviewed, and a phenomenological lifeworld approach was used. Nourishing an infant and having initial breastfeeding complications can be understood by the essence and its constituents. Expectations are fulfilled, and expectations come to naught when complications are experienced such as wavering between powerlessness and joy and finding solutions through resistance. The results suggest that lifeworld-led caring may lead to deepened acknowledgment and the possibility for mothers to feel supported in their extreme situations.

Young witnesses of intimate partner violence: screening and intervention

Intimate partner violence is a public health problem worldwide. Many children witness intimate partner violence at home and are affected by it. Regardless of the degree of exposure, children growing up in violent homes experience negative effects in the form of externalising behaviour and internalising symptoms which call for targeted interventions for children. The aim of the study is to map i) the available methods of detecting child and adolescent witnesses of intimate partner violence and ii) the interventions to support them. Three databases, PubMed, PsychInfo and Social Services Abstracts, were searched for scientific publications spanning over 20 years (1997–2017). This resulted in 2,406 publications of which 15 were finally selected after screening. Analysis of the articles resulted in three categories. The process of detecting children and adolescents who witnessed IPV in their homes varied in the included studies. The children were most commonly identified through their mother or other caregivers. Very few studies were based on children’s own reporting of their experiences, but were rather based on the mothers’ proxy reports. Studies distinguishing between the different forms of violence witnessed by children were few. It was uncommon that children were directly identified or screened for witnessing IPV in the family.

HIV-related stigma and health-related quality of life among children living with HIV in Sweden

The relationship between HIV-related stigma and health-related quality of life (HRQoL) among children living with HIV infection is unknown. The objectives of this study were to describe HIV-related stigma and HRQoL among children with perinatal HIV living in Sweden, and to investigate the relationship between these two factors in the same infection group. In a cross-sectional nationwide survey, HIV-related stigma was measured with the 8-item HIV Stigma Scale for Children. HRQoL was measured with the 37-item DISABKIDS Chronic Generic Module. Structural equation modeling was used to explore the relationship between HIV-related stigma and HRQoL. Fifty-eight children participated, age 9-18 years (mean = 13.9). The HIV stigma general scale showed a mean score of 17.6 (SD = 5.0; possible range 8-32). DISABKIDS Chronic Generic Module general scale showed a mean score of 80.7 (SD = 14.1; possible range 0-100). HIV-related stigma was negatively associated with HRQoL (standardized β = -0.790, p = .017). The results indicate that children's concerns related to disclosure of their HIV infection seem to be common (i.e. 75% agreed) which, together with the negative association between ratings of HIV-relatively stigma and HRQoL, might indicate that disclosure concerns would be a relevant target for interventions to decrease HIV-related stigma and increase HRQoL.

Psychometric properties of a short version of the HIV stigma scale, adapted for children with HIV infection

BACKGROUND

HIV is a stigmatizing medical condition. The concept of HIV stigma is multifaceted, with personalized stigma (perceived stigmatizing consequences of others knowing of their HIV status), disclosure concerns, negative self-image, and concerns with public attitudes described as core aspects of stigma for individuals with HIV infection. There is limited research on HIV stigma in children. The aim of this study was to test a short version of the 40-item HIV Stigma Scale (HSS-40), adapted for 8-18 years old children with HIV infection living in Sweden.

METHODS

A Swedish version of the HSS-40 was adapted for children by an expert panel and evaluated by think aloud interviews. A preliminary short version with twelve items covering the four dimensions of stigma in the HSS-40 was tested. The psychometric evaluation included inspection of missing values, principal component analysis (PCA), internal consistency, and correlations with measures of health-related quality of life (HRQoL).

RESULTS

Fifty-eight children, representing 71% of all children with HIV infection in Sweden meeting the inclusion criteria, completed the 12-item questionnaire. Four items concerning participants' experiences of others' reactions to their HIV had unacceptable rates of missing values and were therefore excluded. The remaining items constituted an 8-item scale, the HIV Stigma Scale for Children (HSSC-8), measuring HIV-related disclosure concerns, negative self-image, and concerns with public attitudes. Evidence for internal validity was supported by a PCA, suggesting a three factor solution with all items loading on the same subscales as in the original HSS-40. The scale demonstrated acceptable internal consistency, with exception for the disclosure concerns subscale. Evidence for external validity was supported in correlational analyses with measures of HRQoL, where higher levels of stigma correlated with poorer HRQoL.

CONCLUSION

The results suggest feasibility, reliability, as well as internal and external validity of the HSSC-8, an HIV stigma scale for children with HIV infection, measuring disclosure concerns, negative self-image, and concerns with public attitudes. The present study shows that different aspects of HIV stigma can be assessed among children with HIV in the age group 8-18.

Experiences of young adults growing up with innate or early acquired HIV infection--a qualitative study

AIM

To explore the experience of young adults growing up and living with HIV in urban Sweden.

BACKGROUND

HIV has become a widespread pandemic. Effective antiretroviral treatment has dramatically increased the survival rate of infected individuals, such that HIV infection is currently considered a chronic disease where treatment is available. Data concerning the experience of living with HIV since early childhood is scarce and more empirical knowledge is needed to direct the development of adequate care and interventions for this growing demographic.

DESIGN

Exploratory qualitative study.

METHOD

Semi-structured interviews were conducted with ten HIV-infected young adults over the period from January-August 2008. Transcripts of the interviews were analysed using qualitative content analysis.

FINDINGS

The analysis revealed five categories illustrating the experiences of growing up and living with HIV in Sweden: (1) to protect oneself from the risk of being stigmatized; (2) to be in control; (3) losses in life, but HIV is not a big deal; (4) health care/healthcare providers; and (5) belief in the future.

CONCLUSION

It is essential to offer a safe, trustworthy, and professional healthcare environment during the upbringing of HIV-infected children. Evidence-based interventions are needed to improve care and support, particularly about the handling of stigma and discrimination.