Bente Birkeland

• Birkeland, Bente; Vederhus, John-Kåre; Selbekk, Anne Schanche; Anne-Marie, Laslett,; Mary, Wilson, Ingrid & Haugland, Siri Håvås (2026). Violence exposure and quality of life among partners and parents of individuals with substance use problems. Frontiers in Public Health. 14. doi: 10.3389/fpubh.2026.1863383. Full text in Research Archive Show summary

  Background: Substance use problems (SUP) have significant adverse consequences not only for individuals with such problems, but also for their loved ones. One important concern is exposure to violence among affected family members. This study investigates whether close family members, specifically partners or parents, of individuals with SUP, including alcohol, face increased risks of physical and sexual violence and emotional abuse within the last 5 years. We also examined a hypothesized mediation model linking SUP exposure, violence, and quality of life (QoL).Methods: We conducted a cross-sectional analysis using data from 17,640 adults aged 23 years and above who participated in the Norwegian Counties Public Health Survey 2023. Multivariable logistic regressions were performed, controlling for age and socioeconomic status, and stratified by gender. Latent regression analysis was used to examine the relationship between SUP exposure and QoL.Results: Gender-specific analyses revealed that partners or parents of individuals with SUP had significantly higher odds of experiencing physical violence (women OR 4.54; men OR 4.14), sexual violence (women OR 4.31; men OR 4.80), and emotional abuse (OR 2.96 across genders). These family members also reported lower QoL. The association between family member status and lower QoL was statistically accounted for by experiences of violence. Information on the perpetrator was not available, and the source of reported violence could therefore not be determined.Conclusion: Close family members such as partners or parents of individuals with SUP face substantial risks of violence and emotional harm and report lower QoL. Support services should offer gender-sensitive, tailored assistance that addresses family members' needs as individuals, not solely as caregivers. These findings highlight the importance of recognizing affected family members as a vulnerable population within public health initiatives.

• Hørte, Cathrine; Vederhus, John-Kåre; Strømland, Monica; Haugland, Siri Håvås; Birkeland, Bente & Abildsnes, Eirik (2026). Adult support and its role in the association between childhood adversity and quality of life in a population-based study. Discover Public Health. 23(1). doi: 10.1186/s12982-026-02634-2. Full text in Research Archive Show summary

  Abstract Background Childhood adversities can have long-term impacts on quality of life (QoL), health, and well-being. We surveyed an adult population to assess the prevalence of three common adverse childhood experiences (ACEs): parental alcohol problems, parental mental illness, and violence from caregivers, as well as the overlap between them. We additionally examined the prevalence of adult support across ACE exposure and how this support related to perceived childhood difficulties and adult QoL. Methods This cross-sectional study used retrospective data from the Norwegian Counties Public Health Survey in Agder 2023. Data were summarized descriptively, and a Venn diagram illustrated the overlap between ACEs. We examined associations between cumulative exposure and the presence or lack of adult support and how these factors related to perceptions of childhood difficulties and adult QoL using one-way analysis of variance. Results The most prevalent ACEs were parental mental illness and parental alcohol problems (16% and 14%, respectively), while ~ 10% reported violence from a caregiver. We observed substantial overlap amongst the three ACE categories, with 2.4% having experienced all three. Adult support was inversely associated with higher levels of ACE exposure, and analysis showed a pattern of increasing perceived childhood difficulties and decreasing QoL scores. Adult support was consistently associated with the perception of a less difficult childhood and higher QoL, among subjects with the same level of ACE exposure. Conclusions Our findings emphasize the importance of adult support within the context of ACEs, and the need for enhanced measures aimed at supporting those most affected.

• Romedal, Signegun; Selbekk, Anne Schanche; Haugland, Siri Håvås; Vederhus, John-Kåre & Birkeland, Bente (2026). Designing their Own Story: A Meta-Ethnography of Health Promotion Among Adolescents with Parental Substance Use Problems. Nordic Studies on Alcohol and Drugs (NAD). ISSN 1455-0725. 43(3), p. 235–260. doi: 10.1177/14550725261436976. Full text in Research Archive Show summary

  Aims Children and adolescents living with parental substance use problems (PSUP) are at potential risk of developing cognitive, behavioral, psychosocial and emotional difficulties affecting their health. However, little is known about how they themselves understand and promote their own health and well-being. This meta-ethnography aims to integrate and synthesize qualitative studies that have explored – from a salutogenic health-promoting perspective – how adolescents living with PSUP express health promotion and well-being, focusing on resources for positive health. Methods The seven iterative phases by Noblit and Hare were followed. Systematic literature searches yielded 13 articles. Results “Designing their own story” was identified as an overarching metaphor accentuated by three main themes that we named: (1) “controlling before opening up”; (2) “choosing trusted support”; and (3) “learning for life”. The overarching metaphor symbolizes how adolescents living with PSUP demonstrate agency in a stressful life situation, expressing a sense of control in everyday life and actively choosing whom to involve for support. Conclusions Supplementing protection and prevention, a different view on narrative of adolescents living with PSUP emerges in the conceptual framework of salutary health promotion. When support is offered, this can inform professionals, service providers and policymakers about the significance of acknowledging and exploring the resources within the adolescents themselves and in their environments. Further research is needed to gain a broader and deeper understanding of how to support adolescents living with PSUP in a health-promoting direction, recognizing their potential to improve their health and well-being in their stressful and challenging life situation.

• Ordahl, Monica Øvensen; Vederhus, John-Kåre & Birkeland, Bente (2024). Utforskning av mentorordningen ved et kommunalt, langtids rehabiliteringstilbud for mennesker med rusmiddelavhengighet – en kvalitativ studie. Nordisk tidsskrift for livskvalitet og bærekraftig velferdsutvikling. 3(3), p. 179–194. doi: 10.18261/njwel.3.3.5. Full text in Research Archive Show summary

  I denne studien undersøkte vi erfaringer med en mentorordning blant beboere i rehabilitering for rusmiddelavhengighet i en kommunal kontekst, med et spesielt fokus på betydningen av det å være mentor for egen bedringsprosess. Vi utforsket også eventuelle utfordringer knyttet til mentorordningen. Datamaterialet er basert på kvalitativ metode, og vi gjennomførte tematisk analyse av syv semistrukturerte intervjuer fra beboere som hadde vært på Jegersberg gård (JG) i omtrent ett år. Funnene beskriver mulighetene og utfordringene ved mentorordningen. De ble oppsummert i temaene: 1) ansvar for andres ve og vel, 2) formidlere av håp, 3) fra byrde til ressurs, 4) «Er det noe som dukker opp, venter vi ikke til de ansatte kommer», og 5) når forventningene ikke ble innfridd. Deltakerne hadde en sterk oppfatning av at mentorfunksjonen var en viktig og nyttig ordning for fellesskapet og driften av et slikt rehabiliterende bofellesskap i kommunal regi. Mentorordningen ble fremhevet som et viktig redskap i den enkeltes bedringsprosess, både for beboerne og mentorene selv. Noen aktuelle utfordringer ved mentorrollen nevnes. En mentorordning synes å være et svært aktuelt og nyttig tiltak i kommunal rehabilitering av mennesker med rusmiddelavhengighet.

• Vederhus, John-Kåre; Timko, Christine; Birkeland, Bente; Haugland, Siri Håvås & Gabrielsen, Karin Berle (2024). Validation of an ultra-short global quality of life scale in a large population-based health survey. PLOS ONE. 19(8). doi: 10.1371/journal.pone.0307539. Full text in Research Archive Show summary

  Introduction Quality of life (QoL) assessment is essential in health-related research and clinical settings, offering insights into individuals’ well-being and functioning. This study validated the Essential QoL-3 (EQoL-3), an ultra-short scale assessing essential dimensions of QoL, for use in epidemiological research and clinical settings. Methods Data from a 2021 national survey in Norway (N = 17,487) were used. Three items on the EQoL-3 assess life satisfaction, happiness, and meaningfulness on a 0–10 scale. Discriminant validity was assessed by comparing the EQoL-3 with the Satisfaction with Life Scale (SWLS) and by examining latent mean differences between individuals with adverse life experiences (ALE+) and those without such experiences (ALE-). Convergent validity was evaluated through latent regression analyses comparing the EQoL-3 with a perceived mastery scale and a mental distress scale. Results The discriminant validity of the EQoL-3 was less than optimal when compared with the SWLS. Nonetheless, a multigroup confirmatory factor analysis revealed that the EQoL-3 score was 1.42 (95% CI = 1.33–1.50, p

• Jobling, Nina; Mjåland, Kristian & Birkeland, Bente (2023). Fengselssykepleieres erfaringer med samarbeidet med spesialisthelsetjenesten og fastleger om legemiddelassistert rehabilitering (LAR). Sykepleien Forskning. ISSN 1890-2936. 18. doi: 10.4220/Sykepleienf.2023.91849. Full text in Research Archive Show summary

  Bakgrunn: Legemiddelassistert rehabilitering (LAR) er forankret i spesialisthelsetjenesten og har siden oppstarten i 1998 hatt en kriminalitetsreduserende effekt. Det er likevel mange LAR-pasienter som jevnlig soner dommer i norske fengsler. For at denne pasientgruppen skal få en adekvat LAR-behandling i fengsel, forutsetter det et godt samarbeid mellom ansatte i LAR og fengselshelsetjenesten, hvor også pasienten bør ha en aktiv rolle i sin egen rehabilitering. Det finnes mye forskning på samhandling i helsetjenesten, men det mangler studier som undersøker samhandlingen mellom fengselshelsetjenesten og LAR. Hensikt: Utforske fengselssykepleieres opplevelse av samarbeid med ansatte i LAR-tjenesten. Metode: Undersøkelsen har et kvalitativt design med en induktiv tilnærming. Datasamlingen ble utført med semistrukturerte, individuelle intervjuer. Vi gjorde en tematisk analyse av datamaterialet basert på Johannessen, Rafoss og Rasmussens versjon etter Braun og Clarke. Resultat: Undersøkelsen viser at fengselssykepleierne opplever samhandlingen med LAR-tjenesten som utfordrende ut fra følgende hovedfunn: Det er lite kommunikasjon, informasjonsutveksling og gjensidig forståelse mellom fengselshelsetjenesten og ansatte i LAR. Knappe ressurser og fysisk avstand mellom LAR-foretakene og fengslene kan bidra til at pasienter ikke prioriteres av LAR-ansatte under soning. Fengselssykepleierne erfarer at det er store forskjeller mellom LAR-foretakene på hvordan samarbeidet fungerer, og det er komplisert å finne rett LAR-behandler. Det er særlig utfordrende når fastlegen har behandlingsansvaret. Konklusjon: Studien viser at fengselssykepleiere ved flere fengsler i Norge erfarer trepartssamarbeidet rundt LAR-innsatte som fraværende. LAR-retningslinjen oppfordrer til trepartssamarbeid, noe som ikke ser ut til å fungere i praksis. Konsekvensen kan være at pasienter som mottar LAR-behandling i fengsel, ikke får nødvendig oppfølging i tråd med LAR-retningslinjen.

• Marciuch, Anne; Birkeland, Bente; Benth, Jurate Saltyte; Solli, Kristin Klemmetsby; Tanum, Lars Håkon Reiestad & Mathisen, Ida [Show all 7 contributors for this article] (2023). Personal recovery among people with opioid use disorder during treatment with extended-release naltrexone. Heliyon. 9(7). doi: 10.1016/j.heliyon.2023.e17516. Full text in Research Archive Show summary

  Background and aims: Recovery from substance use disorders (SUD) has traditionally been equated with abstinence. “Personal recovery” however emphasizes recovery as a unique and personal process, supported by changes in connectedness, hope, identity, meaning and empowerment. This study aimed to examine personal recovery in people receiving extended-release naltrexone (XR-NTX); specifically investigate changes in personal recovery during treatment, identify groups of participants following distinct trajectories of recovery, and characteristics predicting group-belonging. Methods: Overall change in recovery (Questionnaire about the Process of Recovery, QPR) score was assessed by linear mixed model in a subsample of 135 people with opioid use disorder (OUD) participating in a 24 + 28-week trial of XR-NTX. Growth mixture model was used to identify potential groups of people following distinct trajectories of personal recovery. Results: Overall, there was a significant change in QPR score during treatment. Four groups with distinct recovery trajectories were identified: “initially low– increase” (G1), “initially average– no change” (G2), “initially high– no change” (G3) and “initially high– increase” (G4). The groups were different with regards to level of psychological distress, social support, and the use of benzodiazepines. In addition, previous participation in opioid agonist treatment programs, current pain, life satisfaction, employment, heroin craving and previous use of heroin also differed between groups. Conclusions: Personal recovery among people receiving XR-NTX follows different trajectories, and various factors are associated with personal recovery. Particular attention regarding psychological distress, social support and heroin use among patients commencing XR-NTX treatment is important to facilitate successful recovery trajectories.

• Marciuch, Anne; Brenna, Ida Halvorsen; Weimand, Bente; Solli, Kristin Klemmetsby; Tanum, Lars Håkon Reiestad & Røstad, Bente [Show all 7 contributors for this article] (2022). Patients’ experiences of continued treatment with extended-release naltrexone: a Norwegian qualitative study. Addiction science & clinical practice. ISSN 1940-0632. 17(1), p. 1–14. doi: 10.1186/s13722-022-00317-2. Full text in Research Archive Show summary

  Background: The opioid antagonist extended-release naltrexone (XR-NTX) in the treatment of opioid use disorder (OUD) is efective in terms of safety, abstinence from opioid use and retention in treatment. However, it is unclear how patients experience and adjust to losing the possibility of achieving an opioid efect. This qualitative study is the frst to explore how people with opioid dependence experience XR-NTX treatment, focusing on the process of treatment over time. Methods: Using a purposive sampling strategy, semi-structured interviews were undertaken with 19 persons with opioid use disorder (15 men, four women, 22–55 years of age) participating in a clinical trial of XR-NTX in Norway. The interviewees had received at least three XR-NTX injections. Qualitative content analysis with an inductive approach was used. Findings: Participants described that XR-NTX treatment had many advantages. However they still faced multiple challenges, some of which they were not prepared for. Having to fnd a new foothold and adapt to no longer gaining an efect from opioids due to the antagonist medication was challenging. This was especially true for those struggling emotionally and transitioning into the harmful use of non-opioid substances. Additional support was considered crucial. Even so, the treatment led to an opportunity to participate in society and reclaim identity. Participants had strong goals for the future and described that XR-NTX enabled a more meaningful life. Expectations of a better life could however turn into broken hopes. Although participants were largely optimistic about the future, thinking about the end of treatment could cause apprehension. Conclusions: XR-NTX treatment ofers freedom from opioids and can facilitate the recovery process for people with OUD. However, our fndings also highlight several challenges associated with XR-NTX treatment, emphasizing the importance of monitoring emotional difculties and increase of non-opioid substances during treatment. As opioid abstinence in itself does not necessarily equal recovery, our fndings underscore the importance of seeing XR-NTX as part of a comprehensive, individualized treatment approach.

• Stavnes, Kristin Anne; Ruud, Torleif; Benth, Jurate Saltyte; Hanssen-Bauer, Ketil; Weimand, Bente Margrethe & Solantaus, Tytti [Show all 13 contributors for this article] (2022). Norwegian health personnel’s compliance with new legislation on children of ill parents: an exploratory cross-sectional multicentre study. BMC Health Services Research. 22(1), p. 1–18. doi: 10.1186/s12913-022-08268-9. Full text in Research Archive Show summary

  Background In 2010 the Norwegian Parliament introduced amendments to the Health Personnel Act requiring all health personnel to inform and offer help to their patients’ children and families. We evaluated whether health personnel adhered to their obligations outlined in the Act and investigated whether family and health services characteristics were associated with the degree of compliance with the legislation. Our study was part of a larger Norwegian multi-site study conducted in five health trusts across Norway, assessing the situation for families living with parental illness. Method: A cross-sectional study using quantitative data obtained from 518 patients 246 children and 278 health personnel was performed. All informants completed a questionnaire, including an instrument corresponding to the obligations in the legislation. Descriptive analyses, factor analysis and logistic regression analysis were used. Results: The legislation was only partially implemented in the clinics of the health trusts. Compared to estimates prior to the introduction of the new legislation, the situation had improved somewhat, but much work remains to be done to fulfil the obligations decreed by law. The more time-consuming the obligations were, the less often they were met. The substance abuse and mental health services followed up on their obligations to a greater extent than did the physical health services. Conversely, children of physically ill parents were better informed by their families than were children of parents with mental health and substance abuse disorders. When asked the same questions, reports from health personnel were more positive compared to those of children and patients regarding the legislation’s fulfillment. Conclusion: Data suggest that there has been a change in the support offered to children of ill parents. Additional work is required, however, for the Health Personnel Act to function as fully intended.

• Friesinger, Jan Georg; Birkeland, Bente & Thorød, Anne Brita (2021). Human-Animal Relationships in Supported Housing: Animal Atmospheres for Mental Health Recovery. Frontiers in Psychology. 12. doi: 10.3389/fpsyg.2021.712133. Full text in Research Archive Show summary

  Being in a relationship with an animal can promote the well-being of people. For many individuals, this usually takes place at home. This study reports about homes for people with mental health problems (with or without co-occurring substance use), who live in supported housing operated by public landlords, entailing tenancies that are usually stricter regarding their pet policies than ordinary homes. We thus addressed the following research questions through ethnographic fieldwork at seven distinct places: which types of human–animal relationships occur in supported housing, and how do they affect the tenants? We analyzed the collected data informed by the Grounded Theory approach and found three types of human–animal relationships within supported housing affecting the tenants differently, namely, “no animals,” “visiting animals,” and “shared/sole ownership of animals.” Animals in the buildings can stage atmospheres that promote solidarity and connectedness among people. In contrast, situations in which animals are forbidden can create emotional tensions between tenants and staff or landlords. When discussing fostering animal atmospheres and limits to keeping pets, we concluded that animals can contribute to the mental health recovery of tenants by creating acknowledgment and rootedness. Therefore, public housing services need to guarantee equal rights to the tenants as they do with every citizen, including the right to keep a pet.

• Brenna, Ida Halvorsen; Marciuch, Anne; Birkeland, Bente; Veseth, Marius; Røstad, Bente & Løberg, Else-Marie [Show all 9 contributors for this article] (2021). ‘Not at all what I had expected’: Discontinuing treatment with extended-release naltrexone (XR-NTX): A qualitative study. Journal of Substance Abuse Treatment. ISSN 0740-5472. 136, p. 1–11. doi: 10.1016/j.jsat.2021.108667. Full text in Research Archive Show summary

  Background: Extended-release naltrexone (XR-NTX), an opioid antagonist, has demonstrated equal treatment outcomes, in terms of safety, opioid use, and retention, to the recommended OMT medication buprenorphine. However, premature discontinuation of XR-NTX treatment is still common and poorly understood. Research on patient experiences of XR-NTX treatment is limited. We sought to explore participants' experiences with discontinuation of treatment with XR-NTX, particularly motivation for XR-NTX, experiences of initiation and treatment, and rationale for leaving treatment. Methods: We conducted qualitative, semi-structured interviews with participants from a clinical trial of XR-NTX. The study participants (N = 13) included seven women and six men with opioid dependence, who had received a minimum of one and maximum of four injections of XR-NTX. The study team analyzed transcribed interviews, employing thematic analysis with a critical realist approach. Findings: The research team identified three themes, and we present them as a chronological narrative: theme 1: Entering treatment – I thought I knew what I was going into; theme 2: Life with XR-NTX – I had something in me that I didn't want; and theme 3: Leaving treatment – I want to go somewhere in life. Patients' unfulfilled expectations of how XR-NTX would lead to a better life were central to decisions about discontinuation, including unexpected physical, emotional, or mental reactions as well as a lack of expected effects, notably some described an opioid effect from buprenorphine. A few participants ended treatment because they had reached their treatment goal, but most expressed disappointment about not achieving this goal. Some also expressed renewed acceptance of OMT. The participants' motivation for abstinence from illegal substances generally remained. Conclusion: Our findings emphasize that a dynamic understanding of discontinuation of treatment is necessary to achieve a long-term approach to recovery: the field should understand discontinuation as a feature of typical treatment trajectories, and discontinuation can be followed by re-initiation of treatment.

• Birkeland, Bente; Weimand, Bente; Ruud, Torleif; Maybery, Darryl & Vederhus, John-Kåre (2021). Perceived family cohesion, social support, and quality of life in patients undergoing treatment for substance use disorders compared with patients with mental and physical disorders. Addiction science & clinical practice. ISSN 1940-0632. 16(1), p. 1–9. doi: 10.1186/s13722-021-00252-8. Full text in Research Archive Show summary

  Purpose: Support from family and other social network elements can be important in helping patients to cope with practical and emotional consequences of diseases. The aim of the study was to examine perception of family and social support and quality of life (QoL) in patients undergoing treatment for substance use disorders (SUDs). We compared them with patients in treatment for mental disorders (MDs) and physical disorders (PDs). Methods: We used data from a national multicenter study that recruited patients (N  =  518) from three treatment domains; SUD treatment units, MD treatment units, and PD treatment units (severe neurological conditions or cancer). Data on family cohesion, social support, and QoL were compared across patient groups. In addition, data on health variables was collected. We used a multiple linear regression procedure to examine how health and support variables were associated with QoL. Results: Family cohesion and social support in the SUD and MD groups were rated at similarly low levels, substantially lower than in the PD group. The SUD group exhibited a somewhat lower QoL than did the PD group, but their QoL was still in the near-to-normal range. In contrast, the MD group had markedly low QoL. When examining factors associated with QoL, we found that greater family cohesion and social support were positively associated with QoL. Mental distress was the strongest factor, and was negatively associated with QoL (beta − 0.15, 95% CI  =  − 0.17/− 0.14, p  <  0.001). Conclusion: Service providers need to be aware of the weaker networks and less regulatory family and/or social support available to patients with SUDs. Providers should focus consistently on the social networks of patients and include patients’ families in treatment processes.

• Weimand, Bente; Birkeland, Bente; Ruud, Torleif & Høie, Magnhild (2020). “It’s like being stuck on an unsafe and unpredictable rollercoaster” : Experiencing substance use problems in a partner. Nordic Studies on Alcohol and Drugs (NAD). ISSN 1455-0725. 37(3), p. 227–242. doi: 10.1177/1455072520904652. Full text in Research Archive Show summary

  Living with a partner with substance abuse problems may induce strains in an individual’s everyday life, including poor health, disrupted family life, and social isolation; this may lead to dropping out of education or work, a lack of safety and support, and facing various dilemmas and stigma. Aim: The purpose of this study was to explore these partners’ everyday life experiences, including their parental roles. Method: A qualitative design comprising qualitative interviews with ten partners and ex-partners was performed, and a thematic analysis was used. Results: The findings demonstrated that sharing their lives, including parenthood, with a partner with substance use problems affected every aspect of the participants’ lives, and entailed being influenced by their partner’s ups and downs. The overall theme, “being stuck on an unsafe and unpredictable rollercoaster”, is explored through three themes: “dilemmas, stigma, and shame”, “lack of safety, security, and support,” and “searching for hope and meaning.” Conclusion: As a result of the negative impact of their circumstances on their everyday lives, these individuals need support to handle the challenges that they face, but often find it difficult to ask for help. Peer support groups seemed helpful in enabling them to find ways out of their situation.

• Vederhus, John-Kåre; Høie, Magnhild & Birkeland, Bente (2020). One size doesn't fit all: A thematic analysis of interviews with people who have stopped participating in Narcotics Anonymous in Norway. Addiction science & clinical practice. ISSN 1940-0632. 15(18). doi: 10.1186/s13722-020-00191-w. Full text in Research Archive
• Birkeland, Bente; Foster, Kim; Selbekk, Anne Schanche; Høie, Magnhild; Ruud, Torleif & Weimand, Bente (2018). The quality of life when a partner has substance use problems: a scoping review. Health and Quality of Life Outcomes. 16:219, p. 1–14. doi: 10.1186/s12955-018-1042-4. Full text in Research Archive Show summary

  Objective: To examine the existing body of knowledge on quality of life (QoL) in partners of people with substance use problems (PP-SUPs) to provide a synthesized summary of the evidence and identify gaps in our knowledge on the QoL of PP-SUPs. Methods: A systematic scoping review was performed. Publications indexed in EMBASE, Medline, PsycINFO, CINAHL, SocINDEX, and CENTRAL were searched for original, empirical, peer-reviewed, full-length research papers that examined QoL in PP-SUPs. Research papers identified through a manual search of key references and known references by co-authors were also included. A total of 3070 abstracts were screened, 41 full-text papers examined, and nine were found to meet the inclusion criteria. Eligibility was determined in two steps by four and two independent researchers, respectively. The main findings were explored by content analysis. Results: Eight of the nine included studies had quantitative designs, one had a mixed methods design, and no qualitative studies were found. Three studies were conducted exclusively among PP-SUPs, whereas the others included various subgroups. A majority of participants were women, and no study was conducted exclusively among men. Nearly half of the studies reported on whether there were minor children in the PPSUPs’ household. The studies used established and generic QoL instruments based on different conceptual and theoretical perspectives on QoL. A majority of the studies found lower QoL in PP-SUPs than in general population, with substance use by the person with a SUP having the most impact on QoL of all evaluated factors. Two studies reported that gender was associated with QoL, with poor QoL being associated with being a male partner and vice versa for female partners. Conclusions: Further research is needed to examine QoL in PP-SUPs exclusively. A variety of QoL instruments covering various, but limited, dimensions of the concept have been used in previous studies of PP-SUPs. Thus, obtaining a comprehensive understanding of PP-SUPs’ QoL is challenging. Both qualitative and largescale quantitative designs should be used in research on QoL in PP-SUPs, particularly among those with a parenting role.

• Birkeland, Bente; Weimand, Bente; Ruud, Torleif; Høie, Magnhild & Vederhus, John-Kåre (2017). Perceived quality of life in partners of patients undergoing treatment in somatic health, mental health, or substance use disorder units: A cross-sectional study. Health and Quality of Life Outcomes. 15(1). doi: 10.1186/s12955-017-0750-5. Full text in Research Archive Show summary

  Background: This study explores (1) differences in socio-demographic, social/familial, and health variables and perceived quality of life (QoL) among partners of patients with somatic illness, mental illness, or substance use disorder (SUD); and (2) identifies factors associated with QoL. Methods: Participants (N = 213) in this cross-sectional study were recruited from inpatient or outpatient services in five hospitals in Norway, 2013-2014. QoL was measured by the QoL-5, a generic five-item questionnaire. Differences between groups were examined using Chi-square for categorical variables and Kruskal-Wallis for contiuous variables. Multiple linear regression analyses were used to examine factors associated with QoL. Results: The mean QoL score was similar to that of a general population sample, and 13% of the sample had a markedly low QoL. Partners in the SUD group experienced worse socio-demographic conditions in terms of occupation and income, but QoL did not differ significantly among the three groups. In a regression model, perceived family cohesion was positively associated with QoL while psychological distress (Symptom Checklist-10) was negatively related to it. The model explained 56% of the variance in QoL. Conclusions: When patients are ill, clinicians should consider the partners' QoL, and brief QoL tools can be used to identify those who are struggling most. Reduced QoL is associated with higher psychological distress and lower family cohesion. Treatment initiatives focusing on these themes may serve as preventive measures to help the most vulnerable families cope with their difficult life situation.

• Vederhus, John-Kåre; Birkeland, Bente & Clausen, Thomas (2016). Perceived quality of life, 6 months after detoxification: Is abstinence a modifying factor? Quality of Life Research. ISSN 0962-9343. 25(9), p. 2315–2322. doi: 10.1007/s11136-016-1272-z. Full text in Research Archive
• Vederhus, John-Kåre; Timko, Christine; Kristensen, Øistein; Hjemdal, Bente & Clausen, Thomas (2014). Motivational intervention to enhance post-detoxification 12-Step group affiliation: A randomized controlled trial. Addiction. ISSN 0965-2140. 109(5), p. 766–773. doi: 10.1111/add.12471. Full text in Research Archive

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• Friesinger, Jan Georg; Birkeland, Bente & Thorød, Anne Brita (2021). Kommuner kan gjøre enkle grep for bedre psykisk helse. Full text in Research Archive
• Birkeland, Bente (2019). The quality of life when a partner has substance use problems - a scoping review. Full text in Research Archive
• Birkeland, Bente (2019). Quality of life (QoL) when your partner has substance use problems (SUP): a scoping review. Full text in Research Archive
• Birkeland, Bente (2019). Quality of life in partners of patioents in the specialist health services: why does it matter? Full text in Research Archive
• Birkeland, Bente; Høie, Magnhild; Ruud, Torleif & Weimand, Bente (2019). Quality of life – why does it matter? Perceived quality of life in partners of patients undergoing treatment in physical health, mental health, or substance use disorder units: a crosssectional study. Full text in Research Archive Show summary

  To explore (1) differences in socio-demographic, social/familial, and health variables, and perceived quality of life (QoL) among partners of patients with physical illness, mental illness, or substance use disorders (SUD); and (2) identify factors associated with QoL. Why is this important? Studies comparing the QoL between partners to patients in different illness populations seems to be limited, especially when they share parenthood for children. Examining the partner's QoL, and factors associated with QoL is important to get a broadened picture of these families’ situation and needs in times of parental illness. What are the main discussion points you will raise in this presentation? • No QoL differences between groups but poorer scores on income/work for SUD-partners • 13 % had markedly low QoL indicating a very difficult situation • QoL covers domains in addition to strict health outcomes• Brief QoL tools might give valuable information about partners’ needs for support

• Birkeland, Bente (2019). Quality of life – why does it matter? Perceived quality of life in partners of patients undergoing treatment in physical health, mental health, or substance use disorder units: a crosssectional study. Full text in Research Archive
• Weimand, Bente; Birkeland, Bente; Hagen, Kristine Amlund & Ruud, Torleif (2015). Hvem er foreldrene, og hvordan er deres situasjon? Full text in Research Archive
• Iversen, Nina Jobling; Birkeland, Bente & Mjåland, Kristian (2021). LAR i fengsel: En kvalitativ undersøkelse av fengselssykepleieres erfaring med legemiddelassistert rehabilitering (LAR). Universitetet i Agder. Full text in Research Archive Show summary

  Background: Despite the fact that drug-assisted rehabilitation (LAR) has a crime-reducing effect, LAR patients are well represented in Norwegian prisons. There is little knowledge about cooperation between LAR and the prison health service around patients during incarceration, and for this reason prison nurses' experience with LAR treatment in prison will be explored. Objective: The purpose of the study is to highlight the prison nurse's experiences with LAR treatment and collaboration with the LAR offices. The study will be able to give LAR and the prison health service increased insight and understanding of each other's context, where the goal is a better collaboration. New knowledge will be used in the treatment of LAR patients, in the prison health service and in other interested parties affiliated with LAR. Furthermore, the study may add new knowledge to the research field. There are limited studies on LAR treatment from the perspective of prison nurses. The study's research question is: How do prison nurses describe their experiences with LAR treatment in prison? Method: The master's thesis is a qualitative study where semi-structured individual interviews are used in data collection. The study has a phenomenological approach, where the interviews seek descriptions of the interviewee's world of life. Analysis of data is inspired by thematic analysis of Braun & Clarke's model. Results: The informants describe different models for medical delivery and focuses on inmates’ mental health in the care of LAR treatment. The diversion makes the responsibility for LAR in prison challenging. The informants describe a lack of cooperation with LAR. Conclusion: The study provides knowledge about how medication delivery is carried out and that diversion of medications is a major problem. The prison nurses take care of the prisoners’ mental health with support calls and daily contact. The prison nurses want more cooperation and interaction with LAR.

• Ruud, Torleif; Birkeland, Bente; Faugli, Anne; Hagen, Kristine Amlund; Hilsen, Marit & Kallander, Ellen Katrine [Show all 13 contributors for this article] (2021). Barn som pårørende. Resultater fra oppfølgingsundersøkelsen. Helsedirektoratet . Full text in Research Archive
• Birkeland, Bente (2019). Life situation when your partner has substance use problems : Quality of life and everyday experiences. Universitetet i Agder. ISSN 9788271179373. Full text in Research Archive Show summary

  Substance use problems (SUPs) in a family member have a highly negative impact on both the person experiencing such problems and his or her relatives. An estimated 10 – 30% of people are affected by SUPs in a close family member. Several studies have been conducted on relatives of people with SUPs, and they have documented strains such as physical and mental health problems, isolation, lack of support, and disturbance of family routines. However, the partners of people with SUPs seem to have been studied mostly from a psychological perspective, using personality pathology as a model to explain them remaining in such a dysfunctional relationship. Furthermore, partners in these families have received limited attention from research as well as from health and social services, and the social and cultural contexts that these family members live in might have been ignored. This seems to particularly be the case if the partner cares for children alongside the person with an SUP. In Norway, legislation and guidelines impose on health and social services that relatives should be included and involved when a family member has an SUP, as well as receive support if they have substantial care tasks or burdens. To inform and include the partners of people with SUPs according to these legislations and guidelines, as well as to be able to identify their specific support needs, focusing on their life situation, quality of life (QoL), and everyday experiences is crucial.

• Birkeland, Bente & Weimand, Bente (2015). Voksne pårørende til personer med rusmiddelproblemer _ En kvalitativ levekårsstudie - "Det gjennomsyrer jo hele livet". Helsedirektoratet. Full text in Research Archive
• Ruud, Torleif; Birkeland, Bente; Faugli, Anne; Hagen, Kristine Amlund; Hellman, Anders & Hilsen, Marit [Show all 15 contributors for this article] (2015). Barn som pårørende - Resultater fra en multisenterstudie. Helsedirektoratet. Full text in Research Archive

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