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Children`s Mental Health -with focus on family arrangements
Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.ORCID iD: 0000-0003-3805-674X
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The main aim of this thesis was to study children’s mental health with focus on family arrangements. The thesis was based on four studies (I-IV). Study number I, III and IV were quantitative studies with cross sectional design, using the Swedish version of Health behaviour in School- aged children (HBSC), including children aged 11, 13 and 15 years. The data was analysed with multiple linear regression analysis (I) and multivariate logistic regression analysis (III, IV). Study II was of qualitative descriptive design, based on 28 interviews with parents living in shared physical custody with their children. The qualitative study was analysed with inductive latent content analysis.

Study I showed that lower levels of SHC and higher levels of SWB were associated with higher degrees of social capital in the family, school and neighbourhood. Social capital in family, school and neighbourhood had a cumulative influence on children’s SHC and SWB. In study II the participating parents described their own as well as the perceptions of their children and former partners. Parents’ perceptions changed from the beginning of shared physical custody, through the current situation, ending with perception of the future. The fifteen year old boys and girls (III) living in shared physical custody were more at risk of being a smoker or having been drunk compared with children living in two parent families. The results of sex <15 years and conduct problems showed that the risks didn’t differ significantly between these two groups. Study IV showed that children living in shared physical custody with their parents were more likely than children in two parent families to report multiple SHC, and low SWB. The variable of communication did not moderate the SHC and SWB of the children in any of these two groups.

This thesis contribute with new and deeper understanding of the relatively new phenomenon: shared physical custody, and its associations to children’s mental health. The parent’s perceptions were an important complement to the children’s self reported health. In order to influence the decreasing mental health among children and adolescents, their opinions contributes to further understanding. Narratives from children, parents and practitioners are required in order to further study the association between children’s health outcomes and different family arrangements. Additional studies are needed to clarify how children’s mental health and different family arrangements are related to school, community economy, and society.

Abstract [sv]

Avhandlingens huvudsyfte var att studera barns mentala hälsa med fokus på familjekonstellationer. Fyra olika studier ligger till grund för avhandlingen (I-IV). Studie I, II och IV var kvantitativa studier med tvärsnittsdesign. Datamaterialet utgjordes av den svenska versionen av Health Behaviour in School- aged Children (HBSC) (Svenska skolbarns hälsovanor). De deltagande barnen var i åldrarna 11, 13 och 15 år. Datamaterialet analyserades med hjälp av multipel linjär regressions analys (I) samt multivariat logistisk regressionsanalys (III, IV). Studie II var av kvalitativ karaktär och baserades på 28 intervjuer med föräldrar som bodde växelvis boende med sina barn. Den kvalitativa studien analyserades med hjälp av induktiv latent innehållsanalys.

Studie I visade att lägre nivåer av SHC (subjektiva hälsobesvär) och högre nivåer av SWB (subjektivt välbefinnande) hade ett samband med högre nivåer av socialt kapital i familjen, skolan och närområdet. Socialt kapital i familjen, skolan och närområdet hade en kumulativ effekt på barnens självrapporterade SHC och SWB. I studie två beskrev de deltagande föräldrarna sina egna upplevelser, samt upplevelser relaterat till barnen samt och den före detta partnern. Föräldrarnas upplevelser förändrades från den första tiden av växelvis boende till nuvarande situation och avslutades med tankar om framtiden. De växelvis boende femtonåriga pojkarna och flickorna i studie III rapporterade ökad risk för att vara såväl rökare som att ha varit berusade jämfört med 15- åringarna i traditionella familjer. Resultaten avseende sex <15 år samt beteendeproblem visade inga signifikanta skillnader mellan dessa två grupper. Studie IV visade att barn som bodde i växelvis boende rapporterade fler subjektiva hälsobesvär och lägre välbefinnande jämfört med barn i traditionella familjer. Kommunikationsvariabeln hade ingen modererande effekt på någon av dessa båda grupper.

Föreliggande avhandling bidrar med såväl ny som fördjupad kunskap för det relativt nya fenomenet, växelvis boende, och dess relation till barns mentala hälsa. Föräldrarnas upplevelse var ett viktigt bidrag till barnens självrapporterade hälsa. För att kunna påverka barn och ungas rapporter om allt sämre mental hälsa, är deras åsikter ett viktigt inslag för ökade kunskaper inom området. Vi behöver barns, föräldrars och yrkesverksammas åsikter för att vidare kunna studera relationen mellan barns hälsoutfall och olika familjekonstellationer. Vi behöver också veta mer om olika familjekonstellationers relation till skolan, närområdet samt det övriga samhället.

Place, publisher, year, edition, pages
Östersund: Mid sweden University , 2013. , 53 p.
Series
Mid Sweden University doctoral thesis, ISSN 1652-893X ; 160
Keyword [en]
family, mental health, parents, risk behaviours, shared physical custody, social capital, subjective halth complaints, subjective well-being
National Category
Nursing
Identifiers
URN: urn:nbn:se:miun:diva-19759ISBN: 978-91-87557-03-3 (print)OAI: oai:DiVA.org:miun-19759DiVA: diva2:642434
Public defence
2013-09-13, F229, Östersund, 10:15 (Swedish)
Opponent
Supervisors
Available from: 2013-08-23 Created: 2013-08-21 Last updated: 2014-02-03Bibliographically approved
List of papers
1. Risk behaviour in Swedish adolescents: is shared physical custody after divorce a risk or a protective factor?
Open this publication in new window or tab >>Risk behaviour in Swedish adolescents: is shared physical custody after divorce a risk or a protective factor?
2013 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 23, no 1, 3-8 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The increase in shared physical custody in Sweden has been dramatic; 20 years ago only a small percentage of adolescents lived in shared physical custody, but currently ∼30% of the adolescents whose parents have separated or divorced divide their residence between parents. We hypothesized that living in shared physical custody or in a single-parent family is associated with a higher prevalence of adolescent risk behaviour than living in a two-parent family. METHODS: Data on 15-year-old adolescents from the 2005/2006 to 2009/2010 Swedish Health Behaviour in School-aged Children (HBSC) survey were analysed using logistic regression. RESULTS: Adolescents living in shared physical custody had slightly higher rates of risk behaviour compared with adolescents from two-parent families, but significantly lower rates than their counterparts from single-parent families. Their odds of being a smoker or having been drunk were 60 and 50% higher, respectively, than those of their counterparts in two-parent families. CONCLUSION: Shared physical custody after marriage break-up seems to constitute a health protective factor for adolescents' health and problem behaviour. In order to deepen our understanding of the positive and negative aspects of shared physical custody, our study should be followed by qualitative analyses and longitudinal studies of adolescents' experiences.

Keyword
Family-structure; Children; Arrangements; Immigrants; Adjustment; Outcomes; Alcohol; Sweden; Parent; Adults
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-17604 (URN)10.1093/eurpub/cks011 (DOI)000314126700003 ()22383476 (PubMedID)2-s2.0-84876552314 (Scopus ID)
Available from: 2012-12-06 Created: 2012-12-06 Last updated: 2013-08-23Bibliographically approved
2. Shared physical custody after family split-up: implications for health and well-being in Swedish schoolchildren.
Open this publication in new window or tab >>Shared physical custody after family split-up: implications for health and well-being in Swedish schoolchildren.
2013 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 102, no 3, 318-323 p.Article in journal (Refereed) Published
Abstract [en]

AIM: In Sweden, shared physical custody following a parental separation has emerged as means for children to keep close relationships with both parents. Previous studies show that children benefit from regular contact with both parents, who share responsibility for their social, emotional, and economic welfare. In this study we investigate any associations between family arrangements, i.e. two parent, single and shared physical custody families and child health outcomes and whether this association was modified by parent-child communication Methods Data on 11-15-year-old children from the 2005/2006 and 2009/2010 Swedish Health Behaviour in School-aged Children survey were analysed using multivariate logistic regression RESULTS: Children in shared physical custody were more likely than children in two-parent families to report multiple health complaints (OR 1.26) and low well-being (OR 1.71). When variables of parent-child communication were entered in the model, the initial differences remained between children living in shared physical custody and those living in two-parent families. Conclusion Children in shared physical custody and single parent families are more at risk of negative outcomes compared to children in two parent families. This association was not modified by parent-child communication in children in shared custody families, indicating that the communication equals that in two-parent family children.

Keyword
HBSC; Health complaints; Parent-child relations; Public health; School-aged children
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-17605 (URN)10.1111/apa.12110 (DOI)000314656600031 ()23190407 (PubMedID)2-s2.0-84873404762 (Scopus ID)
Available from: 2012-12-06 Created: 2012-12-06 Last updated: 2013-08-23Bibliographically approved
3. Health outcomes among Swedish children: the role of social capital in the family, school, and neighbourhood
Open this publication in new window or tab >>Health outcomes among Swedish children: the role of social capital in the family, school, and neighbourhood
2012 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, no 5, 513-517 p.Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of the study was to explore the extent to which Swedish children's perceptions of social capital in the family, school and neighbourhood predicted health complaints and well-being. Methods: The study used data from the Swedish Health Behaviour in School-agedChildren survey. The sample consisted of 3926 children aged 11-15 years. Correlations and hierarchical multiple linear regression were performed. Results: Higher degrees of family, school and neighbourhood social capital corresponded to lower levels of health complaints and higher levels of well-being. Social capital in these three spheres had a cumulative effect on children's health and well-being. Conclusions: Social capital in the family, school and neighbourhood matters for children's health and well-being and the contributions from each context seem to be additive. Besides the family context, investments for improving child health should primarily be in the school, focusing on social relations and on creating safe and cohesive school environments. Neighbourhood social capital is also of importance and so must be taken into consideration when planning childhealth promotion interventions. © 2011 The Author(s)/Acta Pædiatrica.

Keyword
Adolescence; Health Behaviour in School-aged Children; Health complaints; Health promotion; Well-being
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:miun:diva-14903 (URN)10.1111/j.1651-2227.2011.02579.x (DOI)000302349200031 ()2-s2.0-84859594158 (Scopus ID)
Available from: 2011-11-24 Created: 2011-11-24 Last updated: 2013-08-23Bibliographically approved

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