Cultural Medicine unit at LIME (CM)

Our research includes pre- and post-migration-related stress and health, evaluation of interventions (primary, secondary and tertiary), as well as theory and method development.

Research group leader

Solvig Ekblad

Our increasingly global and multicultural society alongside an egalitarian health care policy places new demand on us all. The research area of CM is in multicultural health and care research.

Below some examples of research projects within our group.

Five projects

To increase mental health literacy and human rights among new-coming, low-educated mothers: a culturally, tailor-made group health promotion intervention with participatory methodology addressing indirectly the children

Early mental health promotion measures are needed. Events that elicit stress after arrival in the reception country, “postmigration stress”, have a negative impact on health-related quality of life among newcomers.

Since over ten years, an innovative model of culturally tailored health promotion groups for refugees have been performed by the research group among new-coming refugees and relatives in several Swedish contexts with promising results.

The results are of significance not only for the individual and his/her relatives but also for healthcare and society. We have ongoing collaboration with an NGO and funding from Public Health Agency of Sweden.

This intervention is also significant for chronic patients as foreign born have higher amount of public health disorders (eg diabetes, heart problems, cancer, pain, mental illness) than the Swedish born.

Collaboration

Alexandra Charles von Hofsten, head and founder of 1.6 & 2.6 Million Club and local women/ambassadeurs. Solvig Ekblad is a member in the medical expert group 

Publications

Quality of life and health promotion intervention – a follow up study among Newly-arrived Arabic Speaking Refugees in Malmö, Sweden.
Eriksson-Sjöö T, Cederberg M, Östman M, Ekblad S.
International Journal of Migration, Health and Social Care 2012:8(3):112-126

Culture- and evidence-based health promotion group education perceived by new-coming adult Arabic-speaking male and female refugees to Sweden - pre and two post assessments.
Ekblad S, Asplund M.
Open Journal of Preventive Medicine 2013:3(1):12-21 doi:10.4236/ojpm.2013.31002

Lifestyle course as an investment in perceived improved health among newly arrived women from countries outside Europe.
Ekblad S, Persson-Valenzuela UB
Int J Environ Res Public Health 2014 Oct;11(10):10622-40

Tailor-made group training by clinical staff to empower equity in health towards newly arriving Arabic- and Somali speaking women in Sweden.
Ekblad S, Hjerpe A, Lunding H.
Public Health Panorama: topic of migration and health in the European Region, Journal for the WHO Regional Office for Europe 2016:2(4):466-476 http://www.euro.who.int/en/publications/public-health-panorama

Utrikes födda kvinnor – genus, etnicitet och ohälsa. Från problemorienterat till hälsofrämjande fokus (284-300).
Ekblad, S
I: Ingemo Bonnier (red). Kvinnor och hälsa, så mycket bättre! 21 medicinska experter. Stockholm: Carlsson Bokförlag, 2018. 

Behovsstyrda cirkelträffar i grupp för nyanlända kvinnor med barn minskar upplevd oro/stress om framtiden. En kvalitetssäkring på fem orter. Temanummer kring flyktingskap och hälsa (gästredaktör: professor Ragnar Westerling).
Ekblad S.
Socialmedicinsk tidskrift 2019:1:85-92

Kunskaper och verktyg om mänskliga rättigheter och socialtjänst  i dialog med nyanlända kvinnor förbättrar psykiska hälsan och relationen till barnen: Erfarenheter från cirkelträffar på fyra orter.
Ekblad S, Baldursdottir S.
Socialmedicinsk tidskrift. Specialnummer kring MR 2019:4:534-544

To increase mental health literacy and human rights among new-coming, low-educated mothers with experience of war: a culturally, tailor-made group health promotion intervention with participatory methodology addressing indirectly the children.
Ekblad S
Frontiers in Psychiatry, Community case study. ID 476241 published July 8, 2020:11, article 611, 1-6.

Meetings between residence doctors in family medicine and refugee patients in assessment and follow-up in primary care: develop, text and evaluate in interactive computer system

Technological progress and changes in health care practices, with an increased focus on clinical communication and contemplation, have successively led to the increased use of simulation models (Virtual patients including Virtual interpreter and Virtual supervisor) as a method of instruction, learning and clinical interviewing within the field of medicine. 
To achieve this, CM research group have chosen a strategy of developing computerized patient simulations in national (SU, KI) and international (Harvard) collaborations, where medical students and in future psychology students and resident doctors can practice and provide feedback to a virtual counsellor.

A project has been funded by FORTE and ALF-Ped and PhD-student Erica Rothlind will defend her PhD thesis, preliminary15 December 2020 entitled: Overlooking health acculturation – a grounded theory illustrating the complexity of intercultural consultations in Swedish primary care.

Collaborations, co-supervisors

Helena Salminen, Associate professor at the Division of Family Medicine and Primary Care, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society and affiliated to Akademiskt Primärvårdscentrum, Region Stockholm

Uno Fors, Professor, Chair, Department of Computer and Systems Sciences, (DVS), Stockholm University

Per Wändell, Professor, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society

Publications

The informal curriculum of family medicine - what does it entail and how is it taught to residents? A systematic review.
Rothlind E, Fors U, Salminen H, Wändell P, Ekblad S
BMC Fam Pract 2020 03;21(1):49

Circling the undefined-A grounded theory study of intercultural consultations in Swedish primary care.
Rothlind E, Fors U, Salminen H, Wändell P, Ekblad S
PLoS ONE 2018 ;13(8):e0203383

Innovative training with virtual patients in transcultural psychiatry: the impact on resident psychiatrists' confidence.
Pantziaras I, Fors U, Ekblad S
PLoS ONE 2015 ;10(3):e0119754

Training With Virtual Patients in Transcultural Psychiatry: Do the Learners Actually Learn?
Pantziaras I, Fors U, Ekblad S
Journal of Medical Internet Research 2015:17(2): e46; doi:10.2196/jmir.3497 

Virtual Mrs K: Th  e learners’ expectations and attitudes towards a virtual patient system in transcultural psychiatry
Pantziaras I, Fors U, Ekblad S
Journal of Contemporary Medical Education, 11 July 2014DOI: 10.5455/jcme.20140627042240

Educational potential of a virtual patient system for caring for traumatized patients in primary care.
Ekblad S, Mollica RF, Fors U, Pantziaras I, Lavelle J
BMC Med Educ 2013 Aug;13():110

A pilot study of user acceptance and educational potentials of virtual patients in transcultural psychiatry.
Pantziaras I, Courteille O, Mollica R, Fors U, Ekblad S
International Journal of Medical Education. 2012;3:132-140 ISSN: 2042-6372 DOI:10.5116/ijme.5004.7c78

Submitted

Virtual patients reflecting the clinical reality of primary care . a useful tool to improve cultural competence.
Rothlind E, Fors U, Salminen H, Wändell P, Ekblad S.

Primary care consultations on emotional distress – a part of the acculturation process in patients with refugee backgrounds. A Grounded Theory Approach.
Rothlind E, Fors U, Salminen H, Wändell P, Ekblad S.

Conferences

Circling the Undefined – Intercultural Consultations in Swedish Primary Care.
Rothlind E, Fors U, Slaminen H, Wändell P, Ekblad S.
Presentation of poster at "Svensk allmänmedicinsk kongress" (Swedish General Practice Congress), 8-10 May 2019, in Borås, Sweden.

Circling the Undefined – Intercultural Consultations in Swedish Primary Care.
Rothlind E, Fors U, Slaminen H, Wändell P, Ekblad S.
Presentation of poster at the Nordic Congress of General Practice 2019, on 17-20 June 2019, in Aalborg, Denmark

Main supervisor for doctoral student

Virtual Patients as an innovative educational tool in transcultural psychiatry.
Pantziaras I

Primary care’s opportunities to detect and prevent ill health in children and young people whose parents are on long-term sick leave through conversations

Serious parental illness is a risk factor of ill health in the children of the family. Health care staff in Sweden is legally obliged to ensure that the children of seriously ill parents are informed and have received advice and support regarding their parents’ illness.

In primary health care, no method that can help parents communicate information about their illness to their children exists.

The aim of this doctoral project (Charlotte Oja) is to test the safety and effects of the psycho-educational method “Let´s Talk about the Children” for use in primary health care for helping seriously ill parents to relate information about their illness to their children.

Collaboration, co-supervisors

Tobias Edbom, licensed nurse, PhD, affiliated, Karolinska Institutet, Department of Clinical Neuroscience

Jörgen Månsson, MD, PhD, professor, University of Gothenburg, affiliated at School of Public Health and Community Medicine

Anna Nager, MD, PhD, Karolinska Institutet, Department of Neurobiology, Care Science and Society, Section of Family Medicine

Publications

Informing children of their parent's illness: A systematic review of intervention programs with child outcomes in all health care settings globally from inception to 2019.
Oja C, Edbom T, Nager A, Månsson J, Ekblad S
PLoS ONE 2020 ;15(5):e0233696

Alone Making Life Work for Both of Us- How Children Aged 11–16 View Themselves in Relation to Their Chronically Ill Parents in a Primary Health Care Context.
Oja C, Edbom T, Nager A, Månsson J, Ekblad S
International Journal of Adolescence and Youth, 2019:24(4), https://doi.org/10.1080/02673843.2018.1548360

Submitted

Trying to restore family life by making out that nothing has changed may render parents unable to inform their children about their illness – A qualitative study of parents on long-term sick-leave in primary health care.
Oja C, Edbom T, Nager A, Månsson J, Ekblad S

Interprofessional learning for students in a Swedish primary healthcare setting with virtual patients 

Virtual patients (VPs) are mostly used in healthcare educations for single health discipline students with the aim to teach clinical reasoning and as a part of their professional development. There are few studies about VPs that promote interprofessional learning and yet one study investigating medical and pharmacy students´ preconceptions of using VP-based interprofessional learning within their studies but no such studies from primary healthcare or student professions. The aim is to investigate the students’ perceptions of conditions for interprofessional education in primary healthcare and to create and describe an interprofessional pedagogical virtual patient model. We also wanted to investigate students´ interprofessional learning in a social context with an interprofessional virtual patient case. Carrie Tran is PhD-student.

Collaboration with supervisors

Helena Salminen, Associate Professor at the Division of Family Medicine and Primary Care, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society and affiliated to Akademiskt Primärvårdscentrum, Region Stockholm

Uno Fors, Professor, Chair, Department of Computer and Systems Sciences, (DVS), Stockholm University

Eva Toth-Pal, MD, PhD, Karolinska Institutet, Department of Neurobiology, Care Science and Society (NVS)

Publications

A virtual patient model for students’ interprofessional learning in primary healthcare.
Tran C, Ekblad S, Toth-Pal  E., Fors U, Salminen H.
PLoS ONE, 23 September 2020, https://doi.org/10.1371/journal.pone.0238797

Conferences

Students’ interaction and learning when working with an interprofessional virtual patient model in primary healthcare.
Tran C, Toth-Pal E, Kaila P, Ekblad S, Fors U, Salminen H.
Abstract sent to AMEE 24-28 September, 2019, Vienna, Austria

Protective measures against covid-19: A qualitative study of barriers and own strategies in vulnerable areas and evaluation of user participation in revised, meaningful infection control information

Socio-economically vulnerable groups and minority groups are affected by Covid-19 to a greater extent than the majority population in Sweden and abroad. Overcrowding, multigenerational housing, health status, health literacy, less opportunities to work remotely, higher dependence on public transport, cultural factors and language barriers, are likely factors in this.

Covid-19 has affected some Stockholm areas very hard with rapid disease development. Järva is one of these areas. The need for trustful and meaningful infection control information that is evaluated, adapted for overcrowded families with multigenerational housing is emphasized by local authorities. Researchers at Karolinska Institutet and the Center for 
Occupational and Environmental Medicine, Region Stockholm, will gain insights into the possibilities of following the Public Health Agency's advice among people in Järva. What are the options to avoid public transport, work from home, stay home from work in case of symptoms and keep distance to the elderly? What have they themselves done to reduce infection? What have they heard about other ways to avoid spreading the infection?

The participants are asked to take part in a group interview (4 language groups and one Swedish), informed through a key person they trust, where they discuss these issues together. The results are translated into a report, a revision of a first version of advice (artcovid.se), disseminated locally through user participation and evaluated.

Collaborations

Maria Albin, Professor and Senior Physician, Karolinska Institutet, Unit of Occupational Medicine, Institute of Environmental Medicine, and Associate Professor at Lund University, Division of Occupational and Environmental Medicine. Head of the Centre for Occupational and Environmental Medicine, Region Stockholm.

Antonios Georgelis, Associate Professor, Head of the unit Environmental Medicine, Centre for Occupational and Environmental Medicine, Region Stockholm and Karolinska Institutet, Institute of Environmental Medicine

Publications

Utan kraftfulla insatser riskerar covid-19 att öka hälsoklyftorna.
Tao Wenjing, Bodin T, Burström Bo, Ekblad S, Holmer H, Irestig R, Kristenson M, Kulane A, Lager A, Lönnroth K, Sahlin Torp L, Sarkadi A
Läkartidningen. Debatt 24 april 2020.

Fysisk distansering-korrekt begrepp för att minska smittan.
Wasserman D, Bragesjö M, Dalman Ch, Ekblad S, Franck J, Hedman-Lagerlöf E, Holmes E, Jayaram-Lindström N, Lekander M, Mittendorfer-Rutz E, Olsson MJ, Osika W, Ruiz M, Serlackius E,  Wicksell R.
Läkartidningen Debatt 27 april 2020

Fysisk distansering riskerar minska jämik hälsa.
Ekblad S.
Altinget 28 april 2020.

Research cooperation as an expert (supervisor)

Jenny Löfgren, Associate professor, Karolinska Institutet, Department of molecular medicine and Surgery

Mary Margaret Ajiko, PhD student, Karolinska Institutet, Department of molecular medicine and Surgery, Soroti Regional Referral Hospital, Uganda

Tanja Tomson, PhD, Associate Professor, Karolinska Institutet, Department of Learning, Informatics, Management and Ethics (LIME)

Anne Leppänen, Karolinska Institutet, Department of Learning, Informatics, Management and Ethics (LIME)

Elisabeth Mangrio, pediatric nurse, PhD, senior lecturer, Associate Professor, Malmö University, Faculty Health and Society, Institute for Studies of Migration, Diversity and Welfare

Michael Strange, Associate professor, MIM, Malmö University

Contact

Solvig Ekblad

Research group leader

Documents