Agneta Kullberg

Making sense of safety

Beyond injury prevention The concept of “safety” can have many different meanings. The Concise Oxford Dictionary defines it as “freedom from danger and risks”, while the Merriam-Webster Dictionary describes safety as “the condition of being safe from undergoing or causing hurt, injury, or loss”. According to etymologist Douglas Harper, the word safe first came into use in the English language around 1280, derived from the Old French sauf , which in turn stemmed from the Latin salvus , meaning “uninjured, healthy, safe”. The Latin word is related to the concepts of salus (“good health”), saluber (“healthful”), and solidus (“solid”), all derived from the Proto-Indo-European base word solwos , meaning “whole”.1 Thus, at its root, the concept of safety revolves around wholeness and health. Injury prevention researchers have defined safety as “a state or situation characterised by adequate control of physical, material, or moral threats”, which “contributes to a perception of being sheltered from danger” (Andersson and Svanstrom, as quoted in Welander et al , page 122). Safety is commonly viewed through the lens of specific injury domains: for some researchers in the injury prevention field, safety has come to mean the prevention of crime and violence; for others, a reduction in motor vehicle deaths or a feeling of being out of danger rather than being in a positive state of human growth and development.3 Due to the multitude of views on the definition of safety, a collaborative effort was launched in 1996 by two World Health Organisation (WHO) Collaborating Centers on Safety Promotion and Injury Prevention, sponsored by the Ministry of Health, Quebec, Canada, and Karolinska Institute, Stockholm, Sweden, to develop international consensus on the conceptual and operational aspects of safety and safety promotion.2 A document was published in 1998 entitled Safety and Safety Promotion: Conceptual …

The lived neighborhood: understanding how people with dementia engage with their local environment

Background: In this paper, we report progress on “Neighborhoods: our people, our places” an international study about how people living with dementia interact with their neighborhoods. The ideas of social health and citizenship are drawn upon to contextualize the data and make a case for recognizing and understanding the strengths and agency of people with dementia. In particular, we address the lived experience of the environment as a route to better understanding the capabilities, capacities, and competencies of people living with dementia. In doing this, our aim is to demonstrate the contribution of social engagement and environmental support to social health. Methods: The study aims to “map” local spaces and networks across three field sites (Manchester, Central Scotland and Linkoping, Sweden). It employs a mix of qualitative and participatory approaches that include mobile and visual methods intended to create knowledge that will inform the design and piloting of a neighborhood-based intervention. Results: Our research shows that the neighborhood plays an active role in the lives of people with dementia, setting limits, and constraints but also offering significant opportunities, encompassing forms of help and support as yet rarely discussed in the field of dementia studies. The paper presents new and distinctive insights into the relationship between neighborhoods and everyday life for people with dementia that have important implications for the debate on social health and policy concerning dementia friendly communities. Conclusion: We end by reflecting on the messages for policy and practice that are beginning to emerge from this on-going study.

People diagnosed with dementia in Sweden: What type of home care services and housing are they granted? A cross-sectional study:

Aims: This study aims to examine what types of home care services and housing are granted to people with a dementia diagnosis and how these types are associated with socio-demographic factors (sex, age, marital status, native or foreign born, and regional area). Methods: A cross-sectional study of all people diagnosed with dementia in three Swedish counties was conducted from the medical records in 2012. Logistic regression analysis was carried out to investigate associations between home care services and housing and socio-demographic variables. Results: In total, 17,405 people had a dementia diagnosis, and the majority were women, aged 80+ years, and unmarried. Some 72% were living in ordinary housing and 28% lived in special housing. Of those who lived in ordinary housing, 50% did not receive any home care service. Not receiving any type of home care services was less common for older people and was also associated with being married and living in rural municipalities. The most common home care services granted were home help and personal care. Special housing was more common for older people, unmarried persons, and those living in rural municipalities. Conclusions: Most people with a dementia diagnosis were living in ordinary housing, and, surprisingly, half of those did not receive any type of home care service. This knowledge is essential for making the living conditions and needs of people living with dementia more visible and to provide good home care services for people with dementia and their families.

Living Life and Doing Things Together: Collaborative Research With Couples Where One Partner Has a Diagnosis of Dementia:

The aim of this study is to identify relevant content for a self-management guide by using the outcomes of previous research in combination with knowledge and experiences from couples where one partner has a diagnosis of dementia. The study was carried out in three phases: (a) literature search of previous research related to well-being and couplehood in dementia; (b) interviews with couples with dementia based on the findings of the literature search; and (c) further authentication of the findings within expert groups of people with dementia and carers. For analysis of data, we used a hybrid approach of thematic analysis with combined deductive and inductive approaches. The findings of this study indicated that the four main themes “Home and Neighborhood,” “Meaningful Activities and Relationships,” “Approach and Empowerment,” and “Couplehood” with related subthemes could be appropriate targets for a self-management guide for couples where one partner has a diagnosis of dementia.

Exploring experiences among adopters during the diffusion of a novel dance intervention in Sweden

ABSTRACT There is a demand for interventions aimed at adolescent girls with psychosomatic problems. In 2013, positive results were reported from a dance intervention programme addressing girls with internalizing problems. The research team behind the intervention immediately received requests from municipalities and county councils interested in using the intervention. From an implementation point of view it is unclear what made the intervention spread without an active plan. The aim of this study was to explore adopters’ experiences about the diffusion and initiation of a public health intervention targeting adolescent girls with internalizing problems. Interviews were conducted with 12 people who were engaged in initiating the intervention in different settings. Data were analysed using conventional content analysis, yielding three categories: perceived appeal and trustworthiness, convenient information, and contextual factors. The results reflected that the participants found that there was a need for an intervention and found the dance intervention to be evidence based and not too complex to perform. Further, there was available information on the project which could easily be distributed to decision makers and others. When initiating the intervention, factors related to economy, possibility for collaboration and recruitment were of importance.

Residents’ perspectives on safety support needs in different types of housing areas

Background: Knowledge about conditions that are understood to support safety is important for planning residential safety promotion in interactions with residents. How residents themselves perceive and reason about their own safety needs has seldom been investigated in Scandinavia. Aim: To identify factors perceived to be necessary to feel safe by residents in areas with blocks of flats and detached houses. Methods: Residents in a Swedish municipality were asked an open-ended question on the research topic by a mail survey; 787 residents provided narrative data that were fed into a summative qualitative and quantitative content analysis. Results: A stable social structure in the housing area was perceived to be the central factor in a safety-supportive residential environment. Whereas maintenance of good and reassuring relations was emphasised in detached housing areas, support for management of poor or even fear-provoking neighbour relations was requested from areas with blocks of flats. This finding emphasises the need to reduce the differential exposure to safety-related factors in the living environment. Conclusions: The results of our study encourage the continued use of a setting-orientated safety promotion approach in which residents and other stakeholders are involved. The policy recommendation that can be drawn from the study is that both the subjective and objective dimensions of safety should be identified and considered when developing local safety promotion interventions in community contexts.